临终病人的心理护理

临终护理是指对因病而生命垂危或因年老处于临终阶段人群卫生保健，心理护理和必要的社会服务。只有全面掌握临终病人的心理活动及心理特点，加强对临终病人心理、生理、社会等多方面的关怀，才能更好地提高慢性临终期病人的生命质量。     

老年临终病人的临终关怀

目的探讨临终病人的心理状况及护理特点。方法本着以人为本的原则,实施全方位的整体照护．回顾性讨论我科20例临终老年病人开展临终心理支持与护理。结果让患者在生命的最后阶段舒适、宁静、安详地面对死亡。结论对老年临终病人运用心理情感支持作为护理干预手段,减轻患者身心痛苦,提高病人的生命质量。     

食管癌病人的临终护理

临终护理是病人在经过积极治疗后,仍无生存希望,直到生命结束之前这段时间进行的护理。我国的临终护理教育起步较晚,但现在对临终病人的护理日益受到重视。我院近年来收治晚期食管癌病人6例,护理人员运用临终护理知识,对其实施整体护理,均获满意效果,现将护理体会报告如下。 1 加强心理护理 1.1 临终病人的心理特征 晚期食管癌病人的心理变化是复杂的,可分为以下几种类:①悲伤型;②恐惧绝望型;③乐观型,这一类型很少见,但在实际工作中也可遇到,这种病人多数性格     

恶性肿瘤患者的临终关怀与护理

目的总结3例恶性肿瘤病人临终关怀与护理。方法针对临终患者的心理变化做好相应的心理护理,并根据病情变化做好病人疼痛护理、皮肤护理、饮食护理等。结果 3例临终病人在有限的时光内安详舒适没有遗憾地度过人生的最后时光。结论临终关怀与护理可以减少病人的痛苦,增加病人的舒适感,提高病人的生命质量,维护病人的尊严。     

癌症晩期病人的临终关怀护理

目的：为了探讨临终癌症晚期病人的临终关怀的护理体会。方法报告30例癌症晚期病人实施生活护理和心理护理为主护理措施。结果30例病人临终关怀减轻病人对死亡的恐惧。结论护士在日常护理工作中，对临终病人给予安慰、照顾、关怀，能帮助病人提高生活质量，使病人平静地面对死亡。     

临终关怀在晚期癌肿病人治疗中的作用

家庭临终关怀是通过系统的治疗和护理减轻临终病人的生理心理和精神上的痛苦,维护病人的尊严,提高临终病人的生活质量,使他们安详、平静、舒适地度过人生最后旅程。同时使临终病人家属的身心得到关心和安抚。临终家庭护理可以减轻医院床位紧张,使临床病人在自己最熟悉的环境中得到同医院一样的系统治疗和护理,使癌肿患者在所剩无几的生命岁月中,能够获得最安全、舒适、系统的关怀而平安地离开人世。     

临终病人的临终护理

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.护理人员应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.     

临终护理与体会

临终护理是为满足晚期患者生理、心理、社会需求的全面照顾。在多年来的临床护理工作中,面对患者不幸死亡,而护理人员也经历了由恐惧、悲哀到能以高度职业责任感、同情心满足病人使其无憾离开人世的心理历程。为了减轻临终病人的痛苦,提高病人的生命质量,维护临终病人的尊严,切实做好让患者在最后生命历程中,面对死亡,保持安祥。1988年,天津医学院临终研究中心的建立引起较大的反响。这表明,中国已用现代的医学,护理学,社会学、心理学、伦理学等科学观点和方法来严肃对待人生的终末阶段。本文将对临终患者生理、心理、社会需求及临床取得较好护理方法介绍如下。     

美国内科医师学会《医德手册》第4版(2)

２临终病人的治疗和护理临终病人的治疗和护理是临床实践的重要方面。医护人员应同情病人和家庭，并进行合格的诊治。临终病人也有权希望得到医师的帮助，包括控制症状、心理和精神上的支持、姑息性治疗和适当应用鸦片类制剂，并将病人介绍到护理院等姑息性治疗机构。具有...     

临终护理的现状与展望

临终护理是以病人的生理、心理发展和临终病人及其家属提供全面照护的实践规律为研究对象的一门新兴学科,其目的是以整个人为对象从生理上解除肉体痛苦,心理上缓和对死亡的恐惧不安,社会上使其具有社会成员的自觉协助其完成社会义务,社会伦理方面则使其提高尚存的生命质量。临终护理正是维护患者辞世前的尊严,增强人们对临终生理状态的积极适应能力,使患者在临终前得到恰当的护理和必要的治疗,帮助其安静,幸福地走完生命的历程,为临终患者家属提供包括居丧期在内的生理、心理关怀的立体化社会卫生服务。这种综合全方位的保健服务充分体现了现代化生物心理—社会医学模式的内涵和人类文明与社会道德的进步。     

恶性肿瘤患者临终关怀护理措施

目的阐述恶性肿瘤患者临终关怀的护理。方法主要从建立良好的社会家庭支持体系、临终患者不同心理反应期的护理对策、临终症状体征护理以及对家属的抚慰等方面,减轻晚期癌症患者的心理压力及躯体不适。结果本组120例患者通过临终关怀护理全组患者在精神和心理上均得到满足、焦虑和恐惧减轻,舒适度增加。结论临终关怀护理能减轻临终患者躯体、精神和心理上的痛苦,增加患者的舒适度,提高临终患者的生活质量,使他们安详、舒适、有尊严地走完人生最后旅程。     

我国临终关怀发展中有关问题探讨

临终关怀是一门以临终病人生理、心理特征和临终照护实践规律为研究对象的新兴边缘学科,其目的在于使临终前病人的生命质量得到提高,减轻其肉体及精神上的痛苦,使其平静、舒适、无痛地度过人生的最后时光。根据我国国情改进临终关怀模式,改善伦理环境,加强政府支持和社会资助,有助于临终关怀事业在我国的发展。     

晚期肿瘤患者及家属的心理干预对患者生活质量的影响分析

目的 分析与探讨心理干预对于晚期肿瘤患者的生活质量的影响.方法 对本科室2008~2011年收治的170例晚期肿瘤患者的心理进行分析,按照患者的需求,给予其以临终关怀为中心的心理干预护理,帮助患者能够得到家庭的支持,使得患者身心平衡,最终有尊严地安详地步入死亡.结果 通过对170例晚期肿瘤患者及其家属进行有效的心理干预后,总体的不良心理得到明显的改善,相应的症状和痛苦有所减轻.结论 对于晚期肿瘤患者及其家属,采用适宜的心理干预对于提高患者的生存质量,尽量延长患者的生命有着重要的帮助.本文的结果显示,心理干预在临床对晚期肿瘤患者的治疗与护理过程中值得推广与应用.     

佛教团体参与艾滋病关怀服务的探索与实践

[目的]提高艾滋病感染者、患者及家属的生存质量;探索佛教团体参与关怀的模式。[方法]采取宗教权威介入结合宗教仪式的方式开展工作。[结果]项目实施地目标人群得到了社会的关怀和帮助(包括精神心理帮助、经济帮助、临终关怀、孤儿关怀等),生活及生存质量明显改善,减少了歧视。[结论]在全民信教的地区,宗教介入艾滋病防治工作,发挥了特殊的作用,这一成功的经验对今后工作的开展有着重要的意义。     

Increased access to palliative care and hospice services: opportunities to improve value in health care

Context: A small proportion of patients with serious illness or multiple chronic conditions account for the majority of health care spending. Despite the high cost, evidence demonstrates that these patients receive health care of inadequate quality, characterized by fragmentation, overuse, medical errors, and poor quality of life. Methods: This article examines data demonstrating the impact of the U.S. health care system on clinical care outcomes and costs for the sickest and most vulnerable patients. It also defines palliative care and hospice, synthesizes studies of the outcomes of palliative care and hospice services, reviews variables predicting access to palliative care and hospice services, and identifies those policy priorities necessary to strengthen access to high‐quality palliative care. Findings: Palliative care and hospice services improve patient‐centered outcomes such as pain, depression, and other symptoms; patient and family satisfaction; and the receipt of care in the place that the patient chooses. Some data suggest that, compared with the usual care, palliative care prolongs life. By helping patients get the care they need to avoid unnecessary emergency department and hospital stays and shifting the locus of care to the home or community, palliative care and hospice reduce health care spending for America's sickest and most costly patient populations. Conclusions: Policies focused on enhancing the palliative care workforce, investing in the field's science base, and increasing the availability of services in U.S. hospitals and nursing homes are needed to ensure equitable access to optimal care for seriously ill patients and those with multiple chronic conditions.     

Hospice use for the patient with advanced Alzheimer's disease: the role of the geriatric psychiatrist

Advanced Alzheimer's disease (AD) can place an immense burden on caregivers as they struggle to provide end-of-life (EOL) care for the patient. Palliative care, as delivered by hospice, provides a viable solution. Hospice maintains the patient's quality of life (QOL) and helps the family during the grieving process. However, many providers are not familiar with hospice and its care for advanced AD patients. Geriatric psychiatrists can be central in implementing hospice, and they can remain an important part of the care once it is in place. A principal clinical challenge is establishing the six-month prognosis for such patients, which is a prerequisite for initiating hospice admission.     

基于文献的我国临终关怀对策研究

目的研究我国临终关怀的对策。方法以论文摘要中含有“临终关怀”和“医院”的“与关系”为关键词对“中国期刊全文数据库（web）”进行检索，以文献分析法对检出论文进行分析与总结。结果论文主要观点是倡导临终关怀、主张临床实践、承认资源不足、提议社工介入和强调心理干预。结论医院应建立由社会工作者为骨干的驻院心理干预制度，提供无偿心理干预救济机制。     

Appropriate time frames for data collection in quality of life research among cancer patients at the end of life

Longitudinal research has been recommended as the most appropriate research design to ensure the validity of quality of life assessments. However, high attrition and non-random missing data in quality of life studies for terminal cancer patients raise questions about generalizability of the study, and at worst they may jeopardize interpretation of the results. Appropriate time frames for eliciting information directly from terminal cancer patients can ensure the internal and external validity of quality of life research in end-of-life care, allow health care professionals to detect sensitively the effects of end-of-life care within the shortest intervention period, and make comparisons across studies possible. From a review of the literature, it is recommended that the appropriate time frame for interviewing terminal cancer patients about their quality of life be a weekly assessment schedule based on the following factors: (a) the median survival of terminal cancer patients enrolling in a hospice/palliative care program is approximately 30 days and there are substantial number of patients who die in each week; (b) at the final weeks of life, quality of life and symptoms of some terminal cancer patients change dramatically; and (c) the shortest intervention period that is likely to give a clinically significant effect of end-of-life care management is 1 week after the enrollment in end-of-life care.     

Confusion in the terminally ill: recognition and management

Pain has been managed aggressively by hospice programs. However, other problems, particularly neuropsychiatric problems, such as confusion, can go unrecognized and untreated even in a hospice setting. The resulting disturbing, violent or disruptive behavior will severely detract from the quality of life the patient and family can share together. Dementia and delirium can be diagnosed using a mental status exam. Care-givers can then be informed about the special needs of the patients and prepared for potential problems. Identification of reversible causes for delirium can continue while agitated behavior is managed with behavioral and pharmacologic approaches. Confusion is a common problem in the terminally ill and prompt recognition and management of the potentially disruptive symptom can do a great deal to maximize the quality of the patient's life.