人文关怀在优质护理服务工作中的应用

目的探讨人文关怀在优质护理服务中的运用,强化护理责任感、落实基础护理,提高护理质量,提高患者满意度。方法通过营造良好的病区环境,增强护士综合素质和主动服务的意识,夯实基础护理,提供安全的护理,实施出院后的延续护理等措施,为患者提供优质护理。结果人文关怀在优质护理服务中的运用,切实提高了护士主动服务的意识,患者满意度和护理质量得到了提高,护理纠纷减少,患者满意度由85.77%提高到97.50%(P<0.01)。结论人文关怀在优质护理服务活动中,提升了护士与患者主动沟通的能力,促进患者的恢复,达到真正意义上的护患和谐、医患和谐和社会的和谐。     

住院患者关怀体验的质性研究

目的了解患者在住院期间对护理人员提供关怀服务的体验,帮助护理管理者更好地认识患者的需要和护理服务的效果,为提高护理服务质量提供依据。方法 2011年12月至2012年5月,采用目的抽样法选取某三级甲等医院内科、外科、妇产科、肿瘤科的住院患者24例,运用现象学研究方法对其进行观察和深度访谈,将记录的资料按Colaizzi步骤进行分析。结果对访谈结果进行分析,提炼出的5个主题为:护患人文关怀认知不足、护士服务态度良好、护理关怀服务质量参差不齐、护士对患者心理支持不足、服务硬环境有欠缺。结论护理管理者应加强培养护士的人文关怀意识,提高护士的关怀能力,同时重视对护士的人文关怀,从而使护士更好地为患者提供关怀性服务。     

心灵关怀对癌症居家姑息护理患者希望水平的影响

目的探讨心灵关怀对癌症患者居家姑息护理过程中患者希望水平的影响。方法将90名癌症晚期患者随机分为对照组45例和干预组45例,对照组进行常规的居家姑息医疗服务,干预组在对照组的基础上进行系统的临床心灵关怀服务。对照组和干预组在研究开始前和结束后均采用HERTH希望调查表评定。结果通过实施临床心灵关怀服务后,比较两组的癌症患者希望水平,干预组中癌症患者的希望水平高于对照组(P0.05)。结论居家姑息癌症患者的希望值极低,对进行居家姑息护理中的癌症患者进行系统的心灵关怀可以有效地缓解患者的情绪,提高患者的希望水平,提高患者的生活质量及对生命价值的肯定。     

人文关怀在手术室护理中的应用

目的:探讨人文关怀在手术室护理中的应用效果,为改进护理质量提供临床依据。方法:将140例择期手术患者随机分为对照组和实验组各70例。对照组进行常规手术室护理,实验组在对照组的基础上进行人文关怀护理措施。于出院前采用焦虑自评量表(SAS)和抑郁量表(SDS)对患者心理情况进行评定,通过调查问卷对手术室护理服务的满意度和护理质量进行评定。结果:实验组患者SAS、SDS评分明显低于对照组(P<0.05),患者对护理服务的满意度及护理质量评分均高于对照组(P<0.05)。结论:将人文关怀应用于手术室护理中,降低了患者不良心理反应,提高了护理质量和患者满意度,值得临床各科室推广应用。     

晚期癌症患者的心理、心灵关怀和社会支持探讨

随着肿瘤防控水平的不断提升,对晚期癌症患者提供心理、心灵关怀与社会支持显得越来越重要和有意义。本文综述了晚期癌症患者的心理、心灵和社会支持发展背景、主要内容及常见干预方法,以期晚期癌症患者能得到更好的照顾,提高生存质量。     

开展老年门诊特色服务探讨

全面了解老年门诊患者特点,分析老年患者就诊特殊需求;并遵循生理、心理、社会医学模式,融人文关怀于护理服务中,倡导微笑服务,关怀病体,开展心理疏导,健康宣教及增值服务,努力改善就诊环境为老年门诊患者提供人性化、个性化的优质特色护理服务,构建和谐护患关系,提高老年患者生活质量和生命质量。     

对艾滋病患者的心理护理和关怀的重要性

艾滋病患者的心理护理和对其关怀与支持可理解成为促进和改善HIV感染者／AIDS患者的生存环境，提高其生命和生存质量而采取的一系列措施。国际经验证明：关怀和支持服务在预防控制艾滋病的工作中，显示了不可替代的作用。     

全人护理模式在老年乳腺癌术后患者中的应用实践

我院围绕患者身体、心理、社交、灵性四方面的需求,向50例老年乳腺癌术后患者提供全方位护理服务,提高了其生活质量,同时促进了医患沟通,对于提高护理服务质量及服务内涵具有重要的意义。     

人文关怀护理对骨科病房的护理质量与患者护理满意度的影响效果

目的探讨人文关怀护理对骨科病房的护理质量及患者对护理满意度的影响效果。方法选取我院2013年12月至2017年12月骨科病房收治的136例患者病历,随机将其等分为研究组和对照组,对照组采用常规护理,研究组采用人文关怀护理,比较两组护理质量、护理满意度。结果研究组患者护理质量、患者对护理人员人文关怀能力评分明显高于对照组,差异有统计学意义(P <0. 05);研究组患者对住院环境、护理技能、护理主动性、心理支持及健康教育的护理服务各项评分均明显高于对照组,差距有统计学意义(P <0. 05)。结论骨科病房应用人文关怀护理可有效提高护理质量和患者对护理满意度,并提高骨科护理人员人文关怀能力。     

门诊患者对导医护士人文关怀行为感知体验的质性研究

目的：深入了解门诊患者对人文关怀护理行为的真实感知体验,为指导门诊人文关怀护理工作提供依据。方法采用质性研究中的现象学方法,对33例在四川省达州市某三甲医院就诊的门诊患者进行观察和深入访谈,并进行分析。结果共提炼出5个主题：尊重患者、护理服务及时、专业知识较全面、心理支持、优化服务流程。结论门诊患者对导医护士的人文关怀具有独特的感受,导医护士和管理者应重视患者的看法,积极采取针对性的措施,以提高门诊优质服务的质量。     

Is a biopsychosocial–spiritual approach relevant to cancer treatment? A study of patients and oncology staff members on issues of complementary medicine and spirituality

Background Complementary and alternative medicine (CAM) is increasingly being used by patients with cancer.Objectives Our aim is to compare the attitudes of cancer patients who use CAM to those of nonusers, on issues of CAM, biopsychosocial considerations, and spiritual needs.Methods Questionnaires were administered to patients and medical care providers in a tertiary teaching hospital with a comprehensive cancer center.Results Forty-nine percent of the study patients reported integrating CAM into their conventional care. Health care providers considered psychological and spiritual needs as major reasons for CAM use, while patients considered the familial–social aspect to be more important.Conclusions Cancer patients do not correlate CAM use with spiritual concerns but expect their physicians to attend to spiritual themes. Health care providers involved in oncology cancer care should emphasize spiritual as well as CAM themes. The integration of these themes into a biopsychosocial–spiritual approach may enrich the dialogue between patients and health providers.     

癌症志愿者参与晚期癌症患者安宁疗护的效果研究

目的 组织康复期癌症志愿者参加晚期癌症患者安宁疗护,改善入住安宁疗护示范病房的晚期癌症患者的优质死亡结局。方法 采用随机数字表法将入住安宁疗护示范病房的69例晚期癌症患者随机分成试验组和对照组,康复期癌症志愿者参与试验组的安宁疗护活动,活动内容包括读国学经典、满足1个心愿、心灵的声音主题活动、节日家文化等。两组都由医务工作者组成的安宁疗护小组给予病情评估、安宁疗护计划、中医症状管理、灵性照护之关爱时间等干预措施。采用肿瘤患者生活质量综合评价量表、灵性安适量表和综合性医院焦虑抑郁量表评价两组的生活质量、灵性安适程度和焦虑抑郁情绪。结果 试验组在生活质量的社会/家庭状况维度、灵性安适程度和焦虑抑郁情绪方面都优于对照组,差异均有统计学意义（均P<0.05）;而试验组生活质量的身体状况、情感状况、功能状况3个维度和生活质量总分与对照组比较,差异无统计学意义（均P>0.05）。与干预前比较,干预后两组生活质量、灵性安适程度、焦虑抑郁情绪差异均有统计学意义（均P<0.05）。结论 相比于完全由医务工作者组成的安宁疗护小组,有康复期癌症志愿者参与的安宁疗护活动,能更好地改善晚期癌症患者的优质死亡结局。     

The last days of life of nursing home patients with and without dementia assessed with the palliative care outcome scale

The aim of this study was to assess the Palliative care Outcome Scale (POS) for terminally ill nursing home (NH) patients in the Netherlands. METHODS: A prospective observational study of patients with a life-expectancy of six weeks or less in 16 Dutch NHs. NH staff rated the patient characteristics and measured palliative care with the POS, including items on physical, psychosocial, informational, spiritual and practical aspects. RESULTS: POS nonscores (not applicable; unknown) were mainly found in the psychosocial and spiritual domains, particularly in patients with dementia. Mean scores for non-demented patients and patients with dementia were favourable for the majority of the POS items. CONCLUSION: According to the NH staff, fairly good quality care was provided, but the psychosocial and spiritual aspects of care need to be addressed more in the last days of the dying NH patient's life. The results indicate that the POS is an appropriate instrument to assess not only cancer patients, but also non-cancer and (moderately) severely demented patients.     

Surprising results regarding MASCC members' beliefs about spiritual care

Background

Through our survey of Multinational Association of Supportive Care in Cancer (MASCC) members and its analysis, we sought to gain a broader, more inclusive perspective of physicians’ understanding of patients’ spiritual care needs and improve our approach to providing spiritual care to patients.

Methods

We developed a 16-question survey to assess spiritual care practices. We sent 635 MASCC members four e-mails, each inviting them to complete the survey via an online survey service. Demographic information was collected. The results were tabulated, and summary statistics were used to describe the results.

Results

Two hundred seventy-one MASCC members (42.7 %) from 41 countries completed the survey. Of the respondents, 50.5 % were age ≤50 years, 161 (59.4 %) were women and 123 (45.4 %) had ≥20 years of cancer care experience. The two most common definitions of spiritual care the respondents specified were “offering emotional support as part of addressing psychosocial needs” (49.8 %) and “alleviating spiritual/existential pain/suffering” (42.4 %). Whether respondents considered themselves to be “spiritual” correlated with how they rated the importance of spiritual care (p?≤?0.001). One hundred six respondents (39.1 %) reported that they believe it is their role to explore the spiritual concerns of their cancer patients, and 33 respondents (12.2 %) reported that they do not feel it is their role. Ninety-one respondents (33.6 %) reported that they seldom provide adequate spiritual care, and 71 respondents (26.2 %) reported that they did not feel they could adequately provide spiritual care.

Conclusions

The majority of MASCC members who completed the survey reported that spiritual care plays an important role in the total care of cancer patients, but few respondents from this supportive care-focused organization actually provide spiritual care. In order to be able to provide a rationale for developing spiritual care guidelines, we need to understand how to emphasize the importance of spiritual care and, at minimum, train MASCC members to triage patients for spiritual crises.     

Spiritual care nursing: what cancer patients and family caregivers want

AIM: This paper presents findings from a study that was designed to understand, from the perspective of cancer patients and their family caregivers, what spiritual care is wanted from nurses. BACKGROUND: Distressing and transformative spiritual responses to living with cancer have been documented. Although there is momentum for providing spiritual care, previous research provides scanty and conflicting evidence about what are the clients' wishes or preferences with regard to receiving spiritual care from nurses. METHODS: A convenience sample of 156 adult cancer patients and 68 primary family caregivers, most of whom were Christians, independently completed the Spiritual Interests Related to Illness Scale and a demographic form, both of which were self-completed questionnaires. RESULTS: A variation in responses to items about nurses providing spiritual care therapeutics was observed; means and medians for these items mostly fell between 2 (disagree) and 3 (agree) on a scale of 1-4. Generally, therapeutics that were less intimate, commonly used, and not overtly religious were most welcomed. No significant differences were found between patient and caregiver preferences. A modest, direct correlation was observed between frequency of attendance at religious services and increased preference for nurse spiritual care. CONCLUSION: For both patients and caregivers, nurses must be sensitive to providing spiritual nurture in ways that are welcomed.     

Spiritual support of cancer patients and the role of the doctor

Purpose

Spiritual care is reported as important for cancer patients, but the role of the doctor in its provision is unclear. We undertook to understand the nature of spiritual support for Australian cancer patients and their preferences regarding spiritual care from doctors.

Methods

Using grounded theory, semistructured interviews were conducted with 15 cancer patients with advanced disease in a variety of care settings. Patients were asked about the source of their spiritual support and how they would like their doctors to engage with them on spiritual issues.

Results

Three themes were identified as follows: (1) sources of spiritual support which helped patients cope with illness and meet spiritual needs, (2) facilitators of spiritual support, and (3) role of the doctor in spiritual support. Regardless of religious background, the majority of patients wanted their doctor to ask about their source of spiritual support and facilitate access to it. Patients did not want spiritual guidance from their doctors, but wanted to be treated holistically and to have a good relationship, which allowed them to discuss their fears. Doctors’ understanding of the spiritual dimension of the patient was part of this.

Conclusions

Spirituality is a universal phenomenon. Patients in a secular society want their doctor to take an interest in their spiritual support and facilitate access to it during illness.     

Spirituality, religiosity, and spiritual pain in advanced cancer patients

ContextSpirituality, religiosity, and spiritual pain may affect advanced cancer patients’ symptom expression, coping strategies, and quality of life.ObjectivesTo examine the prevalence and intensity of spirituality, religiosity, and spiritual pain, and how spiritual pain was associated with symptom expression, coping, and spiritual quality of life.MethodsWe interviewed 100 advanced cancer patients at the M.D. Anderson palliative care outpatient clinic in Houston, TX. Self-rated spirituality, religiosity, and spiritual pain were assessed using numeric rating scales (0 = lowest, 10 = highest). Patients also completed validated questionnaires assessing symptoms (Edmonton Symptom Assessment Scale [ESAS] and Hospital Anxiety and Depression Scale), coping (Brief COPE and Brief R-COPE), the value attributed by the patient to spirituality/religiosity in coping with cancer (Systems of Belief Inventory-15R), and spiritual quality of life (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded [FACIT-Sp-Ex]).ResultsThe median age was 53 years (range 21–85) and 88% were Christians. Almost all patients considered themselves spiritual (98%) and religious (98%), with a median intensity of 9 (interquartile range 7–10) of 10 and 9 (range 5–10) of 10, respectively. Spiritual pain was reported in 40 (44%) of 91 patients, with a median score of 3 (1–6) among those with spiritual pain. Spiritual pain was significantly associated with lower self-perceived religiosity (7 vs. 10, P = 0.002) and spiritual quality of life (FACIT-Sp-Ex 68 vs. 81, P = 0.001). Patients with spiritual pain reported that it contributed adversely to their physical/emotional symptoms (P < 0.001). There was a trend toward increased depression, anxiety, anorexia, and drowsiness, as measured by the ESAS, among patients with spiritual pain (P < 0.05), although this was not significant after Bonferroni correction.ConclusionA vast majority of advanced cancer patients receiving palliative care considered themselves spiritual and religious. Spiritual pain was common and was associated with lower self-perceived religiosity and spiritual quality of life.     

Spiritual Care for Individuals with Cancer: The Importance of Life Review as a Tool for Promoting Spiritual Well-Being

ObjectiveTo discuss spirituality in the context of cancer, focusing on the use of life review as a tool to help promote spiritual well-being among individuals with cancer.Data SourcesLiterature regarding spirituality and life review of the author in cancer care provided the foundation for this article.ConclusionReliance on spirituality as an untapped supportive resource may surprise patients and their families when dealing with a diagnosis of cancer. Coming to terms with advancing disease can be a time of internal and spiritual growth. It is important that all members of the health care team make efforts to understand that spirituality is part of the journey that the person with advanced cancer is going through and that life review is one way to promote spiritual well-being among patients with advanced cancer.Implications for Nursing PracticeNurses are ideally placed to provide spiritual care. Using life review, nurses can assist individuals coming to terms with their diagnosis and can positively impact spiritual and psychosocial well-being.     

心灵关怀对癌症患者焦虑、抑郁情绪的影响

目的:探讨心灵关怀对癌症患者焦虑、抑郁情绪的影响.方法:将120例新入院癌症患者随机分为对照组和实验组各60例,对照组采用常规护理、健康教育;实验组采用在此基础上辅以心灵关怀;分别于入院时、出院前对两组采用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行测评,并观察两组效果.结果:出院时两组SAS测评分别43.3%和75.0%,SDS测评分别48.3%和70.2%,实验组显著低于对照组(P＜0.01).结论:心灵关怀通过减轻癌症患者的心理压力、对疾病诊断、治疗产生的不确定感、疼痛和症状困扰等不适,有效减轻癌症患者焦虑、抑郁情绪.