医院开展居丧护理服务概述

摘要：较多发生在医院的死亡患者是因突发严重疾病、创伤或事故。突然发生、无法预料的死亡会使丧亲者产生更为强烈的悲伤反应，如不能有效应对则影响丧亲者身心健康，产生身心并发症。居丧护理干预措施可帮助丧亲者有效应对悲伤和失去，最大限度地降低由于恶性悲伤反应所带来的负性生理和心理反应。本文阐述了医院提供居丧护理服务的重要性和必要性以及医院居丧护理服务的内容及采取的相应措施。关键词：医院；　丧亲者；　悲伤；　居丧护理中图分类号：Ｒ４７　　文献标识码：Ａ　　文章编号：１００１ ４１５２（２００７）０２ ００７２ ０３     

丧亲者哀伤的研究进展

明确丧亲者哀伤的概念及其内涵,阐述哀伤给丧亲者带来的不良影响,介绍丧亲者哀伤的测量工具并分析其影响因素,为丧亲者制订有效的哀伤干预措施提供借鉴。     

对丧亲者的护理

对丧亲者的评价和处理,应该强调早期预防。预防本身虽然不能消除悲伤,重要的是要识别可能发生不良后果的高危人群。不良后果的先兆有七点:(1)围绕死亡的环境对引起悲伤起重要作用;(2)与死者的亲属关系;(3)既往有无丧亲的经历和适应方式;(4)年龄;(5)社会支持;(6)家属中基本工资收入多少也影响丧亲后果;(7)既往容易有精神和健康问题的人在丧亲过程中危险性较大。丧亲评价是进行护理工作的基础。Bohnet 提出在葬礼后1～2周进行丧亲评价,因为此时葬礼     

癌症患者照顾者预期性悲伤评估工具的研究进展

本文介绍了预期性悲伤的相关概念,阐述了国内外癌症患者照顾者预期性悲伤评估工具的发展过程,适用对象,测量内容,信度、效度,使用方法,应用现状等内容,旨在为国内学者选择合适的评估工具提供指导,为研发符合我国文化背景的癌症患者照顾者预期性悲伤测评工具提供参考。     

中枢神经系统肿瘤术后患者行6R程序哀伤辅导1例护理

正哀伤(bereavement)是指个人在失去所爱或所依恋的对象(主要指亲人)时面临的境况,包括悲伤与哀悼2种反应~([1])。大部分人能相对顺利地接受亲人过世的事实,但少部分人表现出强烈而无法平复的哀伤反应,需要疏导丧亲的哀伤情绪~([2])。约10%的丧亲者存在"延长哀伤障碍",如果没有及时地进行干预和治疗,将会给其带来持久的伤害~([3])。哀伤辅导作为安宁疗护的一部分,是指从业人员协助丧亲者疏导哀伤情绪,为丧亲者提供所需咨询、实际支持,     

1例居丧期病人的心理护理

悲伤是居丧者的一种自然情感反应,是经历亲人或朋友死亡的情感和行为反应的一项重要特征.没有预料或突然发生的死亡,则会带给丧亲者更长期的、更深远的影响[1].居丧期护理是医院心理护理的重要内容,接受亲人死亡事实,有效应对失去,顺利度过悲伤期,最大限度地降低由于恶性悲伤反应所带来的负性生理和心理反应,改善病人生活质量和提高生存质量,预防可能发生的健康问题具有重要意义.     

264例汶川地震丧亲者孤独感与其家庭功能的相关关系研究

目的 探讨丧亲者孤独感与家庭功能相关关系.方法 采用便利抽样,使用家庭关怀度问卷(APGAR)和UCLA孤独量表,对264名汶川地震丧亲者的孤独感和家庭功能进行问卷调查.结果丧亲者孤独感均分( 42.06±9.96)分,50％以上丧亲者体验到中等水平的孤独感;孤独感在性别方面差异无统计学意义(P＞0.05),在年龄、经济状况、婚姻状态和家庭结构方面差异有统计学意义(P＜0.01);丧亲者孤独感与家庭功能呈负相关(P＜0.01).结论孤独感是丧亲者普遍存在的心理问题且处于中等水平;丧亲者的家庭功能从不同侧面对其孤独感产生影响,良好的家庭功能有助于减轻孤独感.     

癌症晚期患者丧亲者哀伤反应的质性研究

目的研究癌症晚期患者丧亲者的哀伤反应。方法 2014年6-8月,采用目的性抽样法选取在深圳市人民医院宁养院的15例晚期癌症患者的亲属为研究对象,对其进行深度访谈,采用Colaizzi的7步分析法进行分析、整理并提炼主题。结果癌症晚期患者丧亲个体的哀伤反应主要表现在身体、心理、社会和灵性方面。结论癌症晚期患者丧亲者经历艰难的心理历程,丧子、丧偶和丧亲的哀伤反应存在差异,护理人员应了解丧亲者的需求,帮助丧亲者建立积极的应对方式。     

肿瘤专科护士对癌症患者家属悲伤干预的护理实践

结合悲伤的特点,介绍肿瘤专科护士对家属的悲伤进行护理的临床实践和体会,包括家属在患者进入临终阶段、濒死期及居丧期3个阶段的护理。强调了肿瘤专科护士在帮助临终患者家属及丧亲家属顺利渡过正常悲伤期的重要性。     

癌症患者家庭照顾者预期性悲伤影响因素的研究进展

预期性悲伤指预感到亲人即将离世而出现的丧失经历及体验。文章介绍了预期性悲伤的相关概念,明确了癌症患者家庭照顾者预期性悲伤现状和表现,并以预测丧亲结果的综合风险因素框架作为理论指导,从压力源、个人因素、人际因素、应对方式等方面对癌症患者家庭照顾者预期性悲伤的影响因素进行综述,并提出建立家庭支持系统、成立心理支持辅导小组、加强医护人员的培训和跨学科合作的建议,以期为进一步开展相关研究,探索有效的干预措施提供依据。     

After-death interviews with surrogates/bereaved family members: some issues of validity

After-death interviews with bereaved respondents are an important tool in the repertoire of researchers evaluating the quality of end-of-life care or investigating the experiences of people at the end of life. Despite the importance of after-death interviews to our understanding of the last months of life, the validity of the information gathered has received little attention. In this article, we review some of the available information, drawing on evidence from cognitive psychology as well as from palliative care studies. Findings from cognitive psychology indicate that memory is a dynamic process, influenced by emotion state and the individual's perspective at the time of the event and at recall. Further research is therefore needed to understand better the circumstances, types of information and research questions for which bereaved relatives are valid surrogates for people who have died.     

老年人跌倒风险评估工具研究进展

跌倒是影响老年人健康的重要问题。跌倒危险评估有助于明确老年人的跌倒风险,并进行针对性的干预。本文对国内外老年人跌倒风险相关评估工具的研究进展进行综述,为开发具有我国特色的老年人跌倒风险评估工具提供依据。     

Social media as a recruitment method to reach a diverse sample of bereaved parents

BackgroundRecruiting a diverse group of parents who are grieving the loss of a child into research is challenging. Social media users represent all demographic groups in the United States. Online platforms, such as Facebook and Twitter, may be one potential method to reach and recruit a diverse group of bereaved parents. To our knowledge, this is the first known article to describe social media as a recruitment mechanism for bereaved parents.PurposeThe purpose of this paper is to describe 1) how the social media platforms of Facebook and Twitter were used to recruit bereaved parents into a cross-sectional, online survey, and 2) the effectiveness of social media as a recruitment tool for this population.ConclusionsSocial media has the potential to be an effective recruitment tool to reach a diverse group of users. More research is needed, however, to determine the best methods to reach fathers as well as racial and ethnic minorities.     

Further validation of the Traumatic Grief Inventory-Self Report (TGI-SR): A measure of persistent complex bereavement disorder and prolonged grief disorder

The Traumatic Grief Inventory Self-Report version (TGI-SR) is an 18-item self-report measure. It was designed to assess symptoms of Persistent Complex Bereavement Disorder (PCBD) included in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and Prolonged Grief Disorder (PGD) proposed by an international group of experts in grief. The research in this article used data from a bereaved patient sample and people who lost loved ones in the Ukrainian airplane crash in July 2014. Findings indicated that the TGI-SR is a reliable and valid tool to assess disturbed grief in research and to identify people needing a more comprehensive assessment of their grief in clinical settings.     

Nutritional screening and assessment tools for use by nurses: literature review

AIM: This paper reports a literature review describing the range of published tools available for use by nurses to screen or assess nutritional status of patients/clients, and to examine whether the validity, reliability, sensitivity, specificity and acceptability of the tool have been investigated. Tools developed specifically for use with older adults are not considered in this review. A screening/assessment tool is described as a tool that uses a questionnaire-type format, contains more than one risk factor for malnutrition and gives an assessment of risk. BACKGROUND: The incidence of malnutrition in people cared for by nurses is high and screening or assessment tools are often used to identify those with, or at risk of, malnutrition. METHODS: A comprehensive literature review methodology was employed. A range of electronic databases was searched from 1982 to 2002. Search terms incorporating "nutrition", "screening", assessment, feeding, instrument, tool, validity, reliability, sensitivity and specificity were combined. Manual searches were also conducted. RESULTS: Seventy-one nutritional screening/assessment tools were identified of which 35 were reviewed. Tools not reviewed included those which incorporated significant use of biochemical measures (8), included complex anthropometric measures (3), were concerned specifically with ingestion (4) or were designated for use with an older population (21). The tools reviewed use a wide variety of risk factors for malnutrition, varying from anthropometric measurements to socio-cultural aspects of eating behaviour. Some identify an action plan based on the score obtained. Many have not been subjected to validity and/or reliability testing and yet appear to be in use in clinical practice. The sensitivity, specificity and acceptability of the tools are often not investigated. CONCLUSION: There are many published nutritional screening/assessment tools available for use by nurses to screen or assess the nutritional status of patients/clients. Many have not been subject to rigorous testing. Future work should consider a more standardized approach to the use of these tools.     

Determining older people's needs for care by Registered Nurses: the Nursing Needs Assessment Tool

AIMS: This paper reports a study to determine an appropriate framework for assessing older people's needs for nursing within the policy of 'free nursing', and to attempt to identify valid, reliable and usable assessment tool for determining this eligibility. BACKGROUND: In 2001, the United Kingdom government introduced 'free nursing care' legislation, eligibility for which was subject to a nursing needs assessment. This paper outlines the search for and subsequent development of an appropriate tool for assessing older people's eligibility for free nursing care in Northern Ireland. METHODS: Following a systematic search of the literature, existing tools used in ascertaining older people's nursing needs were identified. Each tool was systematically assessed in accordance with criteria of validity, reliability, usability, comprehensiveness of assessment and ability to quantify nursing care needs. From the findings, an assessment instrument, Nursing Needs Assessment Tool was subsequently developed and tested. Paired assessments of older people were undertaken independently by assessor dyads and evaluated statistically. Assessors' opinions on the usability of the instrument were sought through a focus group. RESULTS: One hundred and ten paired assessments were returned (63%). Overall there was 65% agreement between assessors. Kappa scores indicated good levels of inter-rater reliability. Correlation co-efficient measures reinforced these results. Findings from the focus group confirmed the validity, usability and comprehensiveness of the tool. CONCLUSIONS: The Nursing Needs Assessment Tool is a reliable, valid and usable instrument. This has major implications for the standardization of assessment for older people.     

Identifying the health needs of elderly people using the Omaha Classification Scheme

An examination of what constitutes assessment would help to clarify those aspects which are essential for establishing a suitable nursing plan for clients. There is no consensus on one assessment tool in nursing, and many methods are used. The important areas in a comprehensive assessment (physiological, mental, social and environmental factors) which need to be addressed are covered by the Omaha Classification Scheme (OCS). This paper discusses the application of a research tool (OCS) for assessing the health needs of a given population. The primary focus of this paper is upon the methodology used in the study. A random sample of 500 elderly people was drawn from all elderly people aged 65 years and over, who lived in the rural areas of Isfahan province, Iran. Data were collected to identify the health needs of the population under study using the OCS. The reliability of this research tool was tested for quantitative scores using Cronbach's alpha test. The results showed an acceptable score for reliability ( r =0.78).     

National survey: Developing a common approach to grading of practice in pre-registration midwifery

This paper presents the final phase of a national project exploring grading of practice in programmes leading to registration as a midwife in the United Kingdom. The aim was to develop a generic framework for grading practice, enhancing standardisation while enabling flexibility in application of current and new educational standards. A mixed method on-line survey considered existing practice assessment tools, factors contributing to robust and reliable assessment and perceptions of two assessment tools developed by the research team: a ‘Lexicon Framework’ and ‘Rubric’, which were tested through scenarios. Participants included 170 midwifery and nursing academics, clinicians and students, representing 20 universities in the UK. Seven key themes emerged, from which an ‘Evidence Based Model for Professional Practice Assessment’ was developed. The proposed tools were overall positively evaluated and demonstrated a good level of reliability. A national tool to standardise midwifery practice assessment is recommended, and scope for transferability of our tools to all midwifery programmes and to nursing was identified. Other recommendations include engagement of key stakeholders in development of practice assessment documentation, and maintaining the professional purpose of grading practice as central to the process. A set of key principles for assessing practice is presented.     

Spousal bereavement assessment: a review of bereavement-specific measures

The death of a spouse represents a common form of bereavement among adults and is associated with significant distress and adaptation. This 10-year review of the bereavement literature highlights 12 tools used to assess bereavement in spousally bereaved samples. Pertinent measurement foci and psychometric properties of each tool are presented. Applicability of each tool within the spousal bereavement process is discussed, and aspects of the spousal bereavement process not currently addressed or under-addressed provide direction for future tool development.