临终关怀在肝癌患者服务实践中的应用

临终关怀包括为晚期肝癌临终患者做好临终阶段的抢救工作,注重对昏迷患者的非语言交流,加强临终患者的基础护理,满足家属的合理要求,提供良好的住院环境等。认为临终关怀能使众多晚期肝癌疾病临终患者有尊严、无痛苦地走到人生的终点,提高护理质量。     

对晚期肿瘤患者临终关怀相关问题的思考与分析

探讨晚期肿瘤患者的临终关怀问题。方法对我国晚期肿瘤患者的临终关怀问题进行分析。结果晚期肿瘤患者临终关怀中的主要伦理问题,包括尊重生命、注重生存质量、是否告知实情以及有选择的放弃治疗等。结论晚期肿瘤患者的临终关怀是一项体现人道主义精神的高尚而艰巨的工作,要求临床医务人员必须要具备精湛的医术、高度的责任感等,使患者真正认识到生命的价值与质量。     

老年患者临终关怀影响因素的探讨

我国已进入老龄化社会。临终阶段,是每个人的人生都不可避免的经历。20世纪60年代,世界上出现了一种新型的医疗服务—临终关怀,这是医学界及全社会面临的新课题。它不以延长临终者生存时间为重,而以提高临终阶段生命质量为宗旨。但在具体实践中还存在种种困难。首先是人们在传统的死亡观、伦理道德观及传统医学观认识上的误区;再有执业人员综合素质普遍偏低,服务机构偏少和医保政策支持不足等,这些都影响老年临终关怀事业的发展。     

居家晚期患者临终关怀护理的探讨

目的探讨基层社区卫生服务中心在社区家庭病床对居家晚期患者开展临终关怀服务的可行性及方法。方法回顾性分析61例居家晚期患者的临终护理情况并进行讨论。结果居家晚期患者安详死去者占93%。患者家属满意率为98%。结论本着"以人为本"的原则,对居家晚期患者开展临终关怀护理服务,采用患者亲属参与、医护共同协商治疗护理方案,实施全方位的整体照护具有重大的社会意义。     

晚期肿瘤患者临终关怀的护理效果分析

目的:对晚期肿瘤患者给予临终关怀的护理方式,查看其效果.方法:选择2015年3月至2017年2月期间入住我院的42例晚期肿瘤患者参与研究.随机将患者分成两组,对照组21例,观察组21例.对照组患者采用常规的护理方式进行护理,观察组患者采用临终关怀进行护理,对比两组接受护理后的生活质量的改善情况,并记录两组患者的抢救次数,记录两组患者的死亡率.结果:经过护理干预,观察组患者的生活质量明显优于对照组患者(P<0.05),观察组患者的抢救成功率明显高于对照组患者,观察组的死亡率也明显低于对照组患者(P<0.05).结论:对采用临终关怀的护理方式干预晚期肿瘤患者,有利于提升患者的生活质量,并可以控制患者抢救率和死亡率.     

恶性肿瘤晚期患者临终关怀的护理体会

恶性肿瘤晚期患者病情危重，救治回天乏力，患者面对死亡的威胁，心理忧虑往往大于生理的痛苦。为提高患者的生存质量，临终关怀至关重要。现将我科2年来收治的18例恶性肿瘤晚期患者的临终关怀做回顾探讨。     

临终关怀心理疏导对晚期肿瘤患者的效果

目的 探讨临终关怀心理疏导对晚期肿瘤患者的影响.方法 选取2018年2月-2019年5月期间汕头大学医学院附属肿瘤医院消化内科116例晚期肿瘤患者作为研究对象,按随机数字表法分为观察组和对照组,每组58例.观察组给予临终关怀护理,对照组给予常规化护理,对两组患者护理前后的焦虑测量表(SAS)、抑郁测量表(SDS)、生活...     

癌症患者的心理状态及临终关怀

由于环境、心理等因素的变化,癌症的发病率逐年增加。在临床护理工作中,掌握癌症患者心理变化的规律,将有助于开展对癌症患者的心理护理。美国学者Dr Kubler Ross将癌症临终患者的心理特征分为否认期、愤怒期、协议期、抑郁期、接受死亡期五个阶段。其实临终患者的心理是极其复杂的,应因人施护,因势利导,创造条件给患者最大的支持和安慰。     

肿瘤患者放疗时应注意的问题

放疗是恶性肿瘤的重要治疗手段之一,65%～75%的肿瘤患者在治疗过程中接受过放疗,那么对于这些患者,在放疗过程中有哪些需要注意的问题呢？一、放疗区域体位标记的保护患者体位标记是保证治疗计划准确实施的关键部分,体位标记可能标记在体位固定器如面膜、体膜上,也可能直接标记在体表,     

临终关怀对终末期肿瘤患者生活质量的影响分析

目的 了解临终关怀在改善终末期肿瘤病患生活质量中的效果.方法 对29例终末期肿瘤病患实施全面性临终关怀的临床资料展开回顾性分析.结果 研究组病患实施临终关怀后的生活质量评分明显优于对照组,组间比较差异显著(P<0.05).结论 临终关怀能增强终末期癌症病患生存质量,让他们安心的度过人生最后一程,在临床有推广应用价值.     

Independent hospice care in the community: two case studies

Following its remarkable success over the past 25 years the hospice movement is now at a watershed in its development. The growing legitimacy of palliative care as a health care specialty has coincided with the development of the internal market within public sector services, and the promotion of community care. The impact of these changes is now being felt by the hospice movement and may well result in radically new forms of service provision. The focus of this paper is on the future direction of the hospices. We argue, that in the present policy context the main priority must be palliative care in the community, using two case studies of innovative services to illustrate how this might be achieved. We also explore a variety of factors which may constrain the development of community care for dying people. These include the diminishing experience of families and primary health care workers in managing death and dying and the often strongly held belief that hospice care must be in-patient care. New community services may also face difficulties both in finding a market niche which complements rather than supersedes existing provision, and in securing service contracts where provision cuts across the health and social care divide. These issues are explored through an examination of the models of care developed by the two hospice groups, their integration within existing networks of provision, and their relationship with purchasing authorities.     

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.     

The impact of health literacy on knowledge,Attitude and decision towards hospice care among community‐dwelling seniors

The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community‐dwelling elderly participants. This cross‐sectional study enrolled 990 community‐dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer‐administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.     

Lay carers of patients admitted to a hospice: how caring restricts their lives

The aim of this paper is to examine how caring for a terminally ill person in the domestic home restricts the lives of their lay carers. Fifty-nine lay carers of hospice patients were interviewed in the hospice approximately a week after the patient's admission using a structured and primarily closed choice schedule. Respondents were mainly the spouse or other close kin of terminally ill patients admitted to the hospice. Respondents reported that in the month prior to their admission, patients were highly symptomatic and required a great deal of help with activities of daily living. Forty per cent of patients required help. Three-quarters of the lay carers reported receiving help from one to three other lay carers in looking after the patient. Two thirds of the carers said that either the patient or they themselves, o both, would have benefited from moe help. Ove one thid of carers reported that in the month prior to the patient's hospice admission their own activities had been severely restricted, especially in the areas of visiting friends and relatives and going out to social activities. Activities least affected were looking after other members of the household and going out to paid work.     

循证护理用于原发性肝癌晚期患者临终关怀效果观察

目的：探讨如何做好肝癌患者的临终关怀护理工作。方法：对某院收治的32例原发性肝癌终末期患者,依据循证护理原则,实施最佳关怀和支持护理。结果：患者疼痛减轻,肝性脑病改善,顽固性腹水及自发性腹膜炎部分得到控制,焦虑、恐惧、悲观等不良情绪缓解,严重营养不良改善。结论：临终关怀可有效提高原发性肝癌晚期患者的生活质量。     

外科病人术前心理护理研究

目的:通过研究手术患者的心理问题,实施心理护理,以有效克服患者的心理紧张。方法:分析某医院外科100例手术患者的心理问题和实施的心理护理。结果:患者情绪稳定,手术耐受性好,术后并发症少。结论:通过心理护理,有效克服了患者的心理紧张,提高了手术耐受力和术后的恢复,使手术护理更加科学化和人性化。     

延续性护理干预在小儿支气管哮喘护理中的应用研究

目的观察延续性护理干预对小儿支气管哮喘患者哮喘控制情况的影响。方法选取2016-01至2017-12期间住院的小儿支气管哮喘患者86例,随机分为2组:观察组(n=43)和对照组(n=43)。出院后,观察组采用延续性护理干预,对照组不进行护理干预。结果出院12个月后,观察组患者的第一秒用力呼气量占预计值百分比(forced expiratory volume in the first second,FEV1%)和最大呼气量占正常预计值百分比(peak expiratory flow,PEF)较对照组显著提高,差异有统计学意义(P<0.05)。同时,观察组患者的哮喘控制率较对照组明显改善(P<0.05)。结论延续性护理干预有助于改善患儿的呼吸功能,控制哮喘。     

CCU患者对限制陪护心理反应的调查与分析

目的:探讨CCU(冠心病重症监护病房,以下简称CCU)病人对限制陪护心理反应及对患者康复的影响.方法:将住院CCU患者随机分观察组(不限制陪护)和对照组(只在规定时间内探护)分别于同一时间进行问卷调查,比较两组心理反应程度及康复情况.结果:观察组抑郁、焦虑明显好于对照组(P<0.01),住院日短于对照组.结论:重视CCU住院患者心理反应,鼓励陪护可减轻患者心理压力,更好配合治疗.