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在后急性护理环境中满足息护理需求:"帮助他们活到死去"
1Division of Geriatric Medicine, Pain and Symptom Care Program, University of North Carolina, Chapel Hill 27599-7550, USA. lhanson@med.unc.edu
JAMA
|February 10, 2006
概括
由于在长期护理设施中发生的死亡人数越来越多,这项研究指导医生转移患者进行息治疗. 它强调选择合适的环境,并通过沟通和培训来改善护理.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 很大一部分死亡发生在长期护理机构 (LTCFs).
- 由于人口老龄化和住院时间减少,LTCF正在越来越多地成为终身护理的主要设置.
- 这一趋势需要专注于优化这些环境中的息护理.
研究的目的:
- 为医生提供指导,以确定何时转移到急性后护理机构对需要终端护理的患者有益.
- 概述改善临终期患者护理连续性和治疗目标的沟通策略.
- 确定选择高质量的息和支持服务的急性后护理机构的标准.
主要方法:
- 一个老年患有转移性黑色素瘤的病例说明,以探索转移决策.
- 讨论沟通策略,包括治疗目标和预测症状升级.
- 分析评估不同后急性护理环境 (住院临终关怀,养老院,住院护理设施) 的标准.
主要成果:
- 后急性护理设置在提供宿舍,息护理,护理服务和日常生活支持活动方面有很大的差异.
- 医生和患者必须权衡转移到各种急性后护理机构的好处和风险.
- 有证据表明,通过改进预先的护理规划,员工培训和临床实践变化,可以加强LTCF的息护理.
结论:
- 鉴于人口结构的变化,改善急性后护理环境中的息护理至关重要.
- 加强沟通,仔细选择环境和有针对性的干预措施是改善这些设施生命终端护理的关键.
- 进一步的研究,复制和传播最佳实践对于满足急性后环境中日益增长的息护理需求至关重要.
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