摘要
目的了解上海市社区舒缓疗护(临终关怀)项目试点机构晚期恶性肿瘤临终住院患者的卫生服务需求。方法采用便利抽样法,选取于2014年3月6—20日在上海市18家临终关怀项目试点机构的临终关怀病房住院的晚期恶性肿瘤患者134名。采用自行设计的调查问卷,对患者进行问卷调查。问卷的主要内容包括患者的基本情况、生命质量情况、卫生服务需求、对疾病和死亡的态度。结果 134名晚期恶性肿瘤临终住院患者中,123人(占91.8%)生活不能完全自理,86人(占64.2%)有疼痛;50人(占37.3%)选择积极治疗,仅17人(占12.7%)选择放弃或拒绝治疗,63人(占47.0%)有心理护理需求,18人(占13.4%)有心灵需求,69人(占51.5%)迫切需求家属陪伴,仅25人(占18.7%)对志愿者服务有需求;84人(占62.7%)知晓病情,82人(占61.2%)对疾病的态度听任自然,53人(占39.6%)不愿谈论死亡。不同年龄、信仰、地域、生命质量的患者卫生服务需求间差异有统计学意义(P<0.05)。结论老年及高龄恶性肿瘤患者是社区临终关怀服务的主要对象,患者医疗护理需求较高,心理、精神方面需求未得到满足,期望得到亲友的支持。心理护理、生活护理、镇痛治疗应作为社区临终关怀服务的工作重点,应注重对患者的心理心灵关爱和死亡教育,鼓励家属亲友共同参与。
Objective To investigate the health service needs of terminal inpatients with advanced malignant tumor in community hospice care pilot settings in Shanghai .Methods Using convenience sampling method , we enrolled 134 terminal inpatients with advanced malignant tumor from 18 community hospice care pilot settings in Shanghai from March 6 to 20, 2014.We conducted self -designed questionnaire survey with the patients .The survey content included general data , quality of life, health service needs and attitudes toward disease and death .Results Of 134 terminal inpatients with advanced malignant tumor, 123 （91.8%） couldn′t make self -care, 86 （64.2%） had ache, 50 （37.3%） chose active treatment, only 17 （12.7%） gave up on or refused treatment , 63 （ 47.0%） had needs for psychological care ,, 18 （ 13.4%） had spiritual needs, 69 （51.5%） had urgent needs for relatives′company, only 25 （18.7%） had needs for volunteers′service, 84 （62.7%） knew about their illness condition, 82 （61.2%） let nature take its course, 53 （39.6%） were unwilling to talk about death.Patients with different ages , beliefs, quality of life and from different regions were significantly different in health service needs （P〈0.05） .Gonclusion Old and aged patients with advanced cancer are the main service objects in community hospice care service .The terminal patients hold high -level need for medical and nursing care , their needs for psychological and spiritual care have not been met , and they long to get their family and friends′support.The community hospice care should focus＆amp;nbsp;on psychological care , life care and analgesic therapy .Psychological , spiritual care and death education for terminal patients should be attached importance , and patients′relatives and friends should be encouraged to be involved .
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第22期2655-2661,共7页
Chinese General Practice
基金
2014年上海市杨浦区卫生计生系统“百医登高计划”青年学科骨干人才培养基金项目(杨卫计委党委[2013]26号)
关键词
临终关怀医疗
临终病人
卫生服务需求
Hospice care
Terminally ill
Health services needs and demand
