在养老院获得息护理和临终关怀
J Zerzan1, S Stearns, L Hanson
1Division of General Medicine, CB 7110, 5035 Old Clinic Bldg, University of North Carolina, Chapel Hill, NC 27599-7110, USA.
JAMA
|November 14, 2000
概括
许多老年患者在养老院死亡,但获得息治疗和临终关怀服务仍然有限. 政策变化是必要的,以改善这些居民的终身护理.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 卫生政策 卫生政策
背景情况:
- 养老院越来越多地成为患有慢性疾病的老年人死亡的场所.
- 临终居民经常经历未经治疗的疼痛和社会隔离.
- 对于这些居民来说,获得息治疗和临终关怀的机会是非常有限的.
研究的目的:
- 检查在养老院中使用临终关怀的情况.
- 确定临终老人院住户进入临终关怀和息护理的障碍.
- 提出政策变更,以改善养老院的终身护理.
主要方法:
- 对养老院死亡趋势的分析.
- 审查住院招生数据.
- 检查卫生政策,质量标准和补偿规则.
主要成果:
- 在养老院发生的死亡比例从1986年到1993年增加了.
- 临终关怀显著改善了终身护理,但在养老院的使用不足 (在1997年只有13%的入学者).
- 许多养老院没有宿舍病人,使用方式因地区和管理员态度而异.
结论:
- 当前的健康政策和补偿结构阻碍了老人院的息和临终关怀.
- 障碍包括质量标准,有利于恢复性护理和报销规则.
- 政策,质量标准和补偿激励措施的改革对于提高临终养老院居民获得息和临终关怀的机会至关重要.
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