临床医生如何使用NIV/CPAP进行生命终端护理? 一个专题分析研究研究研究
David Wenzel1, Lucy Bleazard2, Eleanor Wilson3
1School of Medical Sciences, Public Health and Epidemiology, University of Leicester, Leicester, UK dw343@leicester.ac.uk.
BMJ open
|December 23, 2025
概括
医疗保健专业人员面临的挑战是,在生命结束时支持呼吸系统疾病患者使用先进的呼吸系统支持,如非侵入性通风 (NIV) 和持续正气道压力 (CPAP). 解决这些问题需要更好的培训和工作人员的认可.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 抚慰性护理是一种缓解性护理.
- 医疗保健 专业人员 幸福 幸福
背景情况:
- 先进的呼吸辅助,包括非侵入性通风 (NIV) 和持续正气道压力 (CPAP),在患有呼吸系统疾病的患者中越来越多地使用.
- 接受这些疗法的患者的终身护理为医疗保健专业人员,患者和家人带来了独特的伦理,临床和情感挑战.
研究的目的:
- 探索使用先进呼吸系统辅助 (NIV/CPAP) 的呼吸系统疾病患者的良好死亡障碍和促进因素.
- 检查医疗保健专业人员对定义良好的死亡,识别治疗失败,关于治疗中止的决策以及对工作人员的影响的观点.
主要方法:
- 这是一项定性研究,采用半结构化采访,对25名经验丰富的医疗保健专业人员 (医生,护士,理疗师) 在英国的中等护理.
- 使用反射性主题分析来确定与NIV/CPAP终身护理相关的关键主题.
主要成果:
- 五个主题出现了:关于死亡的信念,症状管理,治疗失败的认知,决策过程和治疗的退出.
- 工作人员报告说,积极治疗和舒适性之间的紧张关系,不一致的做法,以及多学科团队中的冲突.
- 护士们描述了大量的心理和关系劳动,而医生们指出,在将家庭与治疗停止决定保持一致方面存在延迟.
结论:
- 在生命结束时照顾NIV/CPAP患者带来了复杂的挑战,突出了结构化培训和跨学科合作的需要.
- 更多地认识到情感和关系劳动,特别是对于护理人员来说,至关重要.
- 进一步的研究应该集中在确保一致和富有同情心的终身护理和戒断实践的策略上.
相关概念视频
Ethical Issues
2.0K
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
2.0K
Ethical Dilemmas II
2.2K
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
2.2K
Endotracheal Intubation II: Nursing Management
2.3K
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
2.3K
Mechanical Ventilation III: Noninvasive Ventilation
479
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
479
Continuing Care
1.8K
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
1.8K
Endotracheal Intubation I: Procedure
7.0K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
7.0K

