PALLIATIVE HOME CARE IN A RURAL SETTING: REFLECTIONS ON SELECTIVE INTERACTIONS

ABSTRACT: Despite the fact that terminally ill patients are approaching the end-stage of their lives, the need for information and continuing involvement in their own care remains paramount and does not necessarily diminish as their dependency increases. This paper supports the view that nurses working in the area of rural palliative care are in an optimum position to establish the kind of relationship with patients and informal carers that augments a sense of involvement, self determination, equity and trust. This is of particular significance to rural palliative care where service provision may be under-resourced and where domiciliary nurses are often the key provider for continuing care and support.     

RURAL PALLIATIVE CARE VOLUNTEER EDUCATION AND SUPPORT PROGRAM

ABSTRACT: The present paper looks at the challenges of palliative care delivery in rural and remote areas and proposes the establishment, education and coordination of a network of palliative care volunteers to assist in the delivery of non-clinical services. The development of a rural palliative care volunteer education and support training package is documented, together with details of the trialling of the package and its evaluation. Possible benefits of the program and some key issues to be considered when establishing a volunteer network are raised.     

恶性疾患晚期姑息照护中潜在的法律问题

对晚期恶性疾病患者进行护理的郑重点不是疾病的根治，而在于提高服务对象尚存在的生命质量，维护其人格尊严，使其在生命的最后历程中，安详地面对死亡，在病人入院至出院或死亡的全过程中，在姑息照护的每一个环蒸上，均有可能涉及到各种各样的潜在的法律问题。现在，卫生法规日益健全，医疗纠纷裁决程序越来越法制化，病人作为消费者，自我保护意识和法律意识也日益增加，护理人员应该认真学法，促使自己自觉地在工作中约束自己的行为，尽职尽责地为晚期患者服务，避免不必要的医疗纠纷。     

高龄老人临终关怀需求意愿调查分析

目的：了解高龄老人对临终关怀需求意愿，为在我国更好的开展临终关怀服务，建立完善的临终关怀服务体系提供科学依据。方法：采用入户问卷调查方式，就成都市小天辖区204位80岁以上高龄老人的一般情况。健康情况和对临终关怀态度进行调查，采用SPPSS8.0对资料进行整理，使用多类结果的Logistic方法-Multinomial Logistic对影响高龄老人临终关怀方式选择的因素进行多因素分析。结果：在选择临终关怀方式时，老人中34.8%的选择对症治疗，20.6%的选择不治疗，17.2%选择听取医生的安排，9.8%选择听取子女伞兵 安排，9.8%的拒绝回答此问题，7.8%的希望继续高技术治疗，职业、生活费来源，家庭功能和IADL对临终关怀方式有影响。结论：高龄老人对临终关怀的态度是支持的，在其中开展临终关怀是可行的，同样为其提供临终关怀服务也是必要的。     

ASSESSING A SUPPORT AND LEARNING NETWORK FOR PALLIATIVE CARE WORKERS IN A COUNTRY AREA OF SOUTH AUSTRALIA

ABSTRACT: Palliative care might be described as a movement within the healthcare systems of many countries which has a strong voluntary backing in the wider community. Much of the developments in Australia have taken place in the metropolitan areas with 'cinderella' services attempting to make provision in rural and remote parts of the country. This paper describes and reviews an action research project designed to provide a support and learning network for palliative care workers in a country area of South Australia, using the telephone and interactive video conference facilities for communication purposes. The lessons of the project have applicability for other healthcare providers in rural and remote parts of Australia.