1288例肿瘤病人临终护理现状调查及护理干预

目的 探讨肿瘤病人临终护理,提高肿瘤病人生命质量.方法 采用问卷调查法,抽取一线城市三所三甲级医院临终护理肿瘤病人1 288例,随机分为两组,一组为接受常规临终护理组,另一组为针对肿瘤病人病情制定护理干预的临终护理组,接受临终护理3个月后比较两组临终护理质量.结果 肿瘤病人常规临终护理质量满意度较低,接受针对肿瘤病人需求制定护理干预的临终护理组的肿瘤病人临终护理质量满意度大大提高.结论 常规的临终护理已不能满足肿瘤病人的需求,改进后的临终护理干预使肿瘤病人临终护理满意度提高,提升了他们的生命质量.     

护理美学在临终护理活动中的应用

目的:研究护理美学在临终护理中的应用效果。方法:将192例临终患者随机分为观察组和对照组各96例,对照组按临终患者常规护理方法进行护理,观察组将护理美学理论应用其中,通过临床观察、问卷调查、交谈等方式,找出临终患者的各种需求,根据其需求,为患者解除痛苦,实施全程优质服务,比较两组患者临终需求满足情况。结果:观察组患者生理需求、心理需求、家属需求、社会需求满足情况均高于对照组(P<0.05)。结论:护理美学有利于临终护理活动的进行和发展,值得临床推广应用。     

临终护理的现状与展望

随着社会老龄化问题的日趋严重,临终病人数目日益增多,临终护理也逐渐受到重视.越来越多的学者对临终护理进行了研究和探索,希望为临终病人及其家属提供全面的身心照顾与支持,以满足晚期病人生理、心理及社会方面的需求.临终护理作为现代护理学中的一个重要分支,体现了新医学模式.     

临终病人的护理

临终护理虽然起步较晚，但却越来越受到重视。本文介绍了临终护理的质量不仅取决于对病人实际需要的满足程度，还取决于对临终病人的亲人，特别是对失去患儿的父母亲和癌症患儿的同胞兄妹的关怀和护理。     

特需病房的临终关怀服务

目的提高临终病人及家属的生活质量。方法建立家庭式临终关怀病房,控制癌症晚期病人的疼痛,制定个性化临终护理计划,做好基础护理和心理护理,给予临终病人家属心理支持,尊重其民族习俗和宗教信仰,遵照病人生前愿望进行尸体料理,帮助家属办理后续事宜。结果提高了临终病人生命质量,满足了病人的心理需要,病人及家属满意度较高。结论在特需病房实施的临终护理模式提高了服务质量和特需医疗服务信任度,扩大了特需医疗服务的影响力。     

临终病人的护理

临终护理虽然起步较晚，但却越来越受到重视，本文介绍了临终护理的质量不仅取决于对病人实际需要的满足程度，还取决于对临终病人的亲人，特别是对失去患儿的父母亲和癌症患儿的同胞史妹的怀和护理。     

癌症晚期病人的临终关怀

对40例癌症晚期病人临终阶段实施临终关怀护理模式,通过建立临终关怀病房,制订个性化临终护理计划,控制癌症晚期病人疼痛,做好基础护理和心理护理,给予病人家属心理支持,使病人在临终阶段生活质量提高,心理需要得到满足,提高病人家属的满意度,从而提高护理服务质量,帮助病人度过人生的最后阶段。     

百岁老年病人的临终护理

[目的]满足百岁老年病人临终期间生理需要的护理,达到帮助减轻疼痛的目的。[方法]给予舒适体位,加强皮肤、口腔、眼部护理,提供适宜环境,增加与临终病人的交流。[结果]8倒百岁老年病人在临终期间得到舒适护理,更加安静、祥和,说明舒适护理对老年病人临终期有促进作用。[结论]临终舒适护理使老年病人亲属更加得到安慰,减轻了悲伤的程度和减少了悲痛的时间,从而提高了死亡的价值。     

百岁老年病人的临终护理

[目的]满足百岁老年病人临终期间生理需要的护理,达到帮助减轻疼痛的目的.[方法]给予舒适体位,加强皮肤、口腔、眼部护理,提供适宜环境,增加与临终病人的交流.[结果]8例百岁老年病人在临终期间得到舒适护理,更加安静、祥和,说明舒适护理对老年病人临终期有促进作用.[结论]临终舒适护理使老年病人亲属更加得到安慰,减轻了悲伤的程度和减少了悲痛的时间,从而提高了死亡的价值.     

晚期肝癌患者临终护理体会

目的探讨晚期肝癌患者的临终护理特点。方法对本科室2007年2月-2008年9月收治的26例晚期肝癌患者实施临终护理,针对晚期肝癌患者病理、心理状况给予基础护理、心理护理、止痛、营养支持等临终护理。结果临终护理减轻了患者身心痛苦及家属的悲痛,患者在安详中离去,取得了良好的医疗效果和社会效益。结论对晚期肝癌患者实施临终护理,既能减轻患者痛苦,满足其要求,又能维护其尊严,使其在平静中安详地走完人生之路。     

Social work and spiritual counseling: results of one state audit

Interdisciplinary care is the foundation of hospice service for the terminally ill. This model of care includes a holistic focus on the patient and family, including not only physical and medical management but also psychological and spiritual needs. The importance of social issues is acknowledged and supported through federal and state regulations requiring social work and spiritual counseling services as a part of the hospice care team. State regulatory reports were analyzed to identify compliance issues for social workers and spiritual counselors within hospice programs in a midwestern state. Problems with care planning, assessment, and bereavement services were identified in this process. Deficiencies point to the opportunities for social work educators to improve the training of future hospice social workers and the challenges involved in training spiritual counselors.     

The social structure of the hospice decision

Two complementary studies examined social structural dimensions of discussions and decisions to enter hospice care. In Study 1, intensive interviews were conducted with caregivers, patients, "other" decision makers, and physicians for 150 hospice cases. In Study 2, survivors of cancer deaths were surveyed by mail. Data from Study 1 showed that the discussion was likely to be initiated by a professional outside the patient's household, that the number of actual participants in the discussion was small, that social network--friends and relatives--were important during the communication and discussion processes, and that the decision to enter hospice care was likely to be made by the caregiver. Data from Study 2 showed the importance of the timing of communications about hospice. Both studies revealed high levels of awareness of hospice care, as well as how social networks, particularly friends and relatives, serve to communicate information about hospice. Implications for the timing of communications related to hospice care, as well as for future research and models of decision-making are discussed.     

The Social Structure of the Hospice Decision

Two complementary studies examined social structural dimensions of discussions and decisions to enter hospice care. In Study 1, intensive interviews were conducted with caregivers, patients, “other” decision makers, and physicians for 150 hospice cases. In Study 2, survivors of cancer deaths were surveyed by mail. Data from Study 1 showed that the discussion was likely to be initiated by a professional outside the patient’s household, that the number of actual participants in the discussion was small, that social network—friends and relatives—were important during the communication and discussion processes, and that the decision to enter hospice care was likely to be made by the caregiver. Data from Study 2 showed the importance of the timing of communications about hospice. Both studies revealed high levels of awareness of hospice care, as well as how social networks, particularly friends and relatives, serve to communicate information about hospice. Implications for the timing of communications related to hospice care, as well as for future research and models of decision-making are discussed.     

危重症患儿临终关怀模式的构建

目的 建立科学、符合临床需要的危重症患儿临终关怀模式。方法 通过文献检索和半结构式访谈,初步建立危重症患儿临终关怀模式函询问卷,选取全国8所儿童医院的24名专家进行2轮函询,并邀请医疗、护理、心理、营养及社工领域的专家进行团体访谈。结果 通过2轮专家函询及团体访谈,确定了危重症患儿临终关怀模式,包括准备阶段、临终阶段、善终阶段,临终阶段的整体性照护包括疼痛管理、营养管理、舒适护理、心理干预。结论 危重症患儿临终关怀模式的科学性和可靠性较好,为危重症临终患儿的护理提供了借鉴。     

我国临终关怀护理发展中亟待解决的问题

随着我国人口老龄化及疾病谱的改变，人们对临终关怀护理的需求也日益增加。虽然目前我国的临终关怀护理取得了长足的发展，然而在其发展中还存在诸多亟待解决的问题，如临终关怀护理的启动问题、缺乏专科护士、质量管理问题、死亡教育问题、社会支持问题、服务问题等。     

我国临终关怀护理发展中亟待解决的问题

随着我国人口老龄化及疾病谱的改变,人们对临终关怀护理的需求也日益增加。虽然目前我国的临终关怀护理取得了长足的发展,然而在其发展中还存在诸多亟待解决的问题,如临终关怀护理的启动问题、缺乏专科护士、质量管理问题、死亡教育问题、社会支持问题、服务问题等。     

Role of the speech-language pathologist in palliative hospice care

In reviewing the literature, there are few articles describing the role of the speech-language pathologist in hospice. Communication impairments can impact upon the hospice team's ability to provide symptom control and supportive psychosocial care, and diminish the patient's ability to guide the decision making process and maintain social closeness with family. Swallowing difficulties may result in discomfort for patients and concern from caregivers. Patient care provided by the speech-language pathologist can align with the framework of the World Health Organization's components of palliative care. Four primary roles of the speech-language pathologist in hospice can be described. (1) To provide consultation to patients, families, and members of the hospice team in the areas of communication, cognition, and swallowing function; (2) To develop strategies in the area of communication skills in order to support the patient's role in decision making, to maintain social closeness, and to assist the client in fulfillment of end-of-life goals; (3) To assist in optimizing function related to dysphagia symptoms in order to improve patient comfort and eating satisfaction, and promote positive feeding interactions for family members and (4) To communicate with members of the interdisciplinary hospice team, to provide and receive input related to overall patient care. Further development of the speech-language pathologist as a participating member of the hospice interdisciplinary team would support the overall goal of providing quality care for patients and families served by hospice.     

A post-hoc analysis of music therapy services for residents in nursing homes receiving hospice care

This study analyzed the use of music therapy for residents in nursing homes receiving hospice care. An ex-post facto design was utilized to evaluate participants' length of life on the hospice program, time of death in relation to last visit by the social worker and music therapist, the number of sessions and total number of minutes spent in direct care by the social worker and music therapist, and care plan needs treated by the nurse, social worker, and music therapist. A total of 80 participants' medical records were randomly selected for this study. All participants were in nursing homes, 40 of whom had been referred to music therapy. Results showed no significant differences on the time of death in relation to last visit by hospice professional, but there were significant differences in the length of life for those receiving music therapy. Females in this study lived significantly longer than males. Participants received significantly more music therapy sessions than social work sessions, and music therapists spent significantly more time in direct care with participants than did social workers. Care plan needs were analyzed graphically and indicate that music therapists meet important needs of participants.     

Hospice Care of the Patient with AIDS

The palliative care of the patient who is dying of Acquired Immunodeficiency Syndrome (AIDS) embraces the same general concepts as does the care of any dying patient. Treatment is aimed at maximizing function and comfort despite progressive physical deterioration. It is important, however, to be aware of those aspects of the biological, psychological, social and spiritual realms that differentiate hospice care of the patient with AIDS from traditional hospice care.