医疗保健专业人员在重症监护病房中治疗停止期间对输出管的看法
Aurélie Perret1, Hannah Wozniak1,2, Sara Cereghetti1
1Intensive Care Unit, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Journal of palliative medicine
|March 3, 2025
概括
重症监护室 (ICU) 的医疗保健专业人员 (HCP) 对作为终身护理的一部分的输出管有着不同的看法. 不适通常源于评估患者的舒适度,以及缺乏管理生命末期症状的专业知识.
科学领域:
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 停止维持生命治疗,包括输出管,是重症监护室 (ICU) 常见的生命终结实践.
- 了解医疗保健专业人员 (HCP) 对输出管的看法对于改善生命终端护理至关重要.
- 现有的文献强调了伦理方面的考虑,但往往缺乏对医疗保健工作者的情感和实际反应的详细见解.
研究的目的:
- 探索ICU医疗保健专业人员 (HCPs) 关于作为生命终结实践的一部分的输出管的看法.
- 评估医务人员的情感和道德反应,对患者痛苦的看法,以及在输出管过程中对死亡声 (DR) 的管理.
- 为了确定导致医务人员在输出管过程中的不适的因素.
主要方法:
- 2019年1月15日至3月15日,在瑞士进行了一项单一集中在线问卷调查.
- 该研究包括在ICU工作的医生,护士和护士助理.
- 收集了有关经验,情绪/道德反应,对患者痛苦的看法以及对死亡声的管理的数据.
主要成果:
- 在227名受邀的医疗保健工作者中,有150人 (66%) 参与. 44%的人对输出管有负面的感受,有些人认为它是暴力的 (15%) 或相当于窒息 (8%).
- 对死亡声 (DR) 的看法各不相同,一些护士和护士助理将其视为痛苦的标志. 大多数医疗保健工作者希望为家庭 (95%) 和个人 (64%) 的舒适性而治疗DR.
- 医务人员不适的主要来源包括缺乏专业知识 (82%),对患者舒适度的担忧 (79%) 和生命不恒性的象征意义 (51%).
结论:
- 虽然用于终身护理的输出管可以在道德上得到证明,但卫生保健工作者对相关的患者痛苦和死亡声 (DR) 持有不同的观点.
- 医疗保健工作人员的不适与评估患者舒适度,管理家庭痛苦以及感知到缺乏专业知识的挑战密切相关.
- 需要进一步的教育和支持,以解决医疗保健工作者的担忧,并提高终身护理在输出管过程中的质量.
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