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The Hospice journal最新文献

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Visions and strategies: what participants and others might do. 愿景和策略:参与者和其他人可能会做什么。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882885
J K Harrold, E Ayers, J Lynn
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引用次数: 1
Complementary therapy: aromatherapy with massage for geriatric and hospice care--a call for an holistic approach. 补充疗法:芳香疗法与按摩的老年和临终关怀护理-呼吁一个整体的方法。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882901
C Howdyshell

The medical profession in America would benefit from including aromatherapy with massage in its care of elderly and hospice patients. The appropriate use of these modalities will enhance the quality of patient care and will compliment conventional treatment regimens. Currently, the medical profession in America treats the pathophysiological diseases of patients, but falls short in treating their emotional needs. Aromatherapy and massage can be used to fill this gap, as well as to improve the patient's response to traditional treatment routines. While there is an abundance of literature extolling the use of essential oils, the articles reflect subjective, individual findings and don't account for the multitude of influencing environmental factors which would include such things as the patient's degree of pain, personality of the person administering care and that of the patient, or even the temperature of the room itself. Further research needs to be made so that scientific, qualitative measurements can be proven and documented.

美国的医疗行业将受益于在老年人和临终关怀病人的护理中加入芳香按摩疗法。这些模式的适当使用将提高病人护理的质量,并将补充传统的治疗方案。目前,美国医学界对患者的病理生理疾病进行治疗,但对患者的情感需求治疗不足。芳香疗法和按摩可以填补这一空白,并改善患者对传统治疗程序的反应。虽然有大量的文献赞美精油的使用,但这些文章反映的是主观的、个人的发现,并没有考虑到影响环境因素的众多因素,包括病人的疼痛程度、护理人员和病人的个性,甚至房间本身的温度。需要进行进一步的研究,以便科学的、定性的测量能够得到证实和记录。
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引用次数: 7
Why not the best for the chronically ill? 为什么不给慢性病患者最好的呢?
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882891
S B Jones

Premium adjustors to neutralize risk selection among health plans are the weakest component in the technology for assuring competitive markets. It will be many years before we have adjustors adequate to free health plans to invest in and market improved managed care to predictably high-cost chronically ill persons. For want of a fair premium, health plans are driven by risk selection to underinvest in and otherwise "demarket" care to these very employees and beneficiaries whose costs and care most need to be managed. To achieve best value for the chronically ill, large employer coalitions, Medicare, and Medicaid should consider radical new approaches, such as establishing separate prices for care to people with specific chronic conditions and purchasing such care both from health plans and directly from provider systems.

在确保竞争市场的技术中,用于中和健康计划之间风险选择的保费调整是最薄弱的部分。我们还需要许多年的时间才能有足够的调整机构来免费投资健康计划,并向可预见的高成本慢性病患者推销改进的管理式医疗。由于缺乏公平的保费,健康计划受到风险选择的驱动,对这些成本和护理最需要管理的雇员和受益人投资不足,或者“去市场化”医疗服务。为了实现慢性病患者的最佳价值,大型雇主联盟、医疗保险和医疗补助应该考虑激进的新方法,例如为患有特定慢性病的人建立单独的医疗价格,并从健康计划和直接从提供者系统中购买此类医疗。
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引用次数: 6
Transformational leadership and the hospice R.N. case manager: a new critical pathway. 变革型领导与安宁疗护个案经理:一条新的关键路径。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882899
C L Lafferty

This article asserts that in light of changing conditions in the healthcare environment, transformational leadership is the most appropriate leadership style for the hospice registered nurse case manager. The author defines transformational leadership and, tracing from early leadership theories, demonstrates how the transformational-transactional leadership paradigm emerged from preceding leadership theories. The components of transformational leadership--transformational behavior and transformational characteristics--are linked to hospice theory and hospice-specific nursing practices. The expanding role of the hospice R.N. case manager is addressed in light of transformational leadership and culture building. Specific actions are proposed in the arenas of research, education, and community, corporate, and legislative involvement.

本文认为,在医疗环境不断变化的情况下,变革型领导是最适合安宁疗护注册护士个案管理者的领导风格。作者定义了变革型领导,并从早期的领导理论追溯,展示了变革型-交易型领导范式是如何从之前的领导理论中产生的。变革型领导的组成部分——变革行为和变革特征——与安宁疗护理论和安宁疗护具体护理实践有关。临终关怀护士个案经理的角色日益扩大,本文将以转型型领导和文化建设的角度来探讨。在研究、教育、社区、公司和立法参与等领域提出了具体行动建议。
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引用次数: 6
God and the search for meaning among hospice caregivers. 上帝与安宁疗护者对生命意义的追寻。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882904
J R Mickley, K I Pargament, C R Brant, K M Hipp

The purposes of this study were (1) to describe both religious and nonreligious appraisals of caregiving for a terminally ill patient and (2) to explore the relationship between these appraisals with situational outcomes, mental health outcomes, and spiritual health outcomes in the caregivers. Ninety-two caregivers completed a questionnaire consisting of religious and nonreligious appraisals, general and religious outcomes, depression, anxiety, and purpose in life. Caregivers who appraised their situation as part of God's plan or as a means of gaining strength or understanding from God reported positive outcomes while caregivers who viewed their situation as unjust, as unfair punishment from God, or as desertion from God had low scores on mental and spiritual health outcomes. Religious appraisals made a significant and unique contribution to the prediction of situational outcomes and mental and spiritual health outcomes above and beyond the effects of nonreligious appraisals.

本研究的目的是:(1)描述对临终病人照护的宗教和非宗教评价;(2)探讨这些评价与照护者情境结果、心理健康结果和精神健康结果之间的关系。92名护理人员完成了一份调查问卷,包括宗教和非宗教评估,一般和宗教结果,抑郁,焦虑和生活目的。那些认为自己的处境是上帝计划的一部分或从上帝那里获得力量或理解的看护者报告了积极的结果,而那些认为自己的处境是不公正的,是上帝不公平的惩罚,或者是离弃上帝的看护者在心理和精神健康方面的结果得分较低。宗教评价对情境结果和心理和精神健康结果的预测做出了重要而独特的贡献,其影响超出了非宗教评价的影响。
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引用次数: 91
Quality end of life care: the case for a MediCaring demonstration. 高质量的临终关怀:医疗示范案例。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882895
J Lynn, A M Wilkinson

People in the last phase of life often need a very different care system than the one currently available. MediCaring extends the hospice model to a larger population with a wider array of services over a longer period of time with an emphasis on symptom management, maintenance of function, comfort and family counseling. This model requires simultaneous efforts to secure longer life and to make the patient and family ready for dying. Services range from psychological and spiritual counseling for the patient and family, to emergency care access, to inpatient respite care. MediCaring would accomplish these goals without increasing costs, primarily by diminishing the use of acute care interventions that may no longer serve the patient.

处于生命最后阶段的人往往需要一种与现有护理系统截然不同的护理系统。医疗将临终关怀模式扩展到更大的人群,在更长的时间内提供更广泛的服务,重点是症状管理,功能维护,舒适和家庭咨询。这种模式需要同时努力确保更长的寿命,并使病人和家属做好死亡的准备。服务范围从对病人和家属的心理和精神咨询,到紧急护理,再到住院病人的临时护理。医疗将在不增加成本的情况下实现这些目标,主要是通过减少可能不再为患者服务的急性护理干预措施的使用。
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引用次数: 28
New endeavors and innovative programs in end of life care. 在临终关怀方面的新努力和创新项目。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882896
A M Wilkinson, J K Harrold, I Kopits, E Ayers

This paper presents summaries of initiatives and demonstration programs developed by professional and patient care organizations to improve care at the end of life.

本文介绍了由专业和患者护理组织开发的倡议和示范项目的摘要,以改善生命末期的护理。
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引用次数: 12
Socialization of hospice volunteers: members of the family. 安宁疗护志工的社会化:家庭成员。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882900
C Sadler, F Marty

The purpose of this study is to examine the turning points volunteers found important in their hospice training and volunteer experiences. Seventeen individuals who had recently completed hospice training were asked about the turning points in their training and volunteering that were important in their becoming and remaining a hospice volunteer. The study finds that volunteers have a wide variety of intrapersonal, interpersonal, and group reasons for becoming and remaining a hospice volunteer. The findings suggest that hospice staff need to create a wide variety of events which volunteers can identify with to help people want to become and remain volunteers.

本研究的目的是探讨志愿者在接受安宁疗护训练及志愿服务经验时所发现的重要转折点。17位最近完成安宁疗护训练的人被问及他们在训练和志愿服务中的转折点,这些转折点对他们成为并保持安宁疗护志愿者很重要。研究发现,志愿者有各种各样的个人、人际关系和群体原因成为并保持安宁疗护志愿者。研究结果表明,临终关怀工作人员需要创造各种各样的活动,志愿者可以认同,以帮助人们想要成为和保持志愿者。
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引用次数: 25
Pain and the barriers to its relief at the end of life: a lesson for improving end of life health care. 生命结束时疼痛及其缓解的障碍:改善生命结束卫生保健的一个教训。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882890
J M Ingham, K M Foley

Pain among cancer patients is a common distressing symptom that frequently affects physical functioning, social interaction, psychological status, and quality of life. Despite the extensive body of knowledge available regarding cancer pain assessment and management, it often remains untreated, thereby diminishing the quality of patient care at the end of life. Recommendations on how to remove these barriers, as well as to improve care of the dying in general, need to be implemented by the U.S. government.

癌症患者的疼痛是一种常见的痛苦症状,经常影响身体功能、社会交往、心理状态和生活质量。尽管关于癌症疼痛的评估和管理有广泛的知识体系,但它往往得不到治疗,从而降低了患者临终时的护理质量。关于如何消除这些障碍的建议,以及如何从总体上改善对临终者的护理,需要由美国政府实施。
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引用次数: 35
The importance of measuring quality of care at the end of life. 衡量生命末期护理质量的重要性。
Pub Date : 1998-01-01 DOI: 10.1080/0742-969x.1998.11882892
M S Donaldson

Although designed to respond to acute illness, the current health care system must increasingly provide care for people living longer with chronic diseases. Evaluation of the quality of this care must utilize appropriate measurements, study populations, and outcomes. Current quality measures and major studies of quality of care are highlighted. A framework for measuring quality of care is outlined.

虽然目前的卫生保健系统旨在应对急性疾病,但必须越来越多地为寿命较长的慢性病患者提供护理。对这种护理质量的评估必须采用适当的测量方法、研究人群和结果。目前的质量措施和护理质量的主要研究突出。概述了衡量护理质量的框架。
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引用次数: 6
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The Hospice journal
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