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The Place of Spiritual Well-Being in Hospice Patients’ Overall Quality of Life 安宁疗护病人整体生活品质之精神健康地位
Pub Date : 2000-06-01 DOI: 10.1080/0742-969X.2000.11882950
Judith E. Thomson
ABSTRACT There is an increasing awareness of, and interest in the relationship between spirituality and health. This research examines spiritual well-being as one of six components of hospice patients’ overall quality of life. Patients admitted over a four-month period were surveyed, using the Functional Assessment of Cancer Therapy scale (FACT-G), at admission, one month later, three months later, and six months later. Data showed spiritual well-being to be an important contributor to overall quality of life. The article concludes by advocating that providing spiritual care to hospice patients makes good business sense. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]
灵性与健康之间的关系越来越引起人们的关注和兴趣。本研究探讨安宁疗护病人整体生活品质的六个组成部分之一,即精神健康。在4个月内入院的患者在入院时、1个月后、3个月后和6个月后接受癌症治疗功能评估量表(FACT-G)的调查。数据显示,精神健康是整体生活质量的重要因素。文章最后主张,为临终关怀病人提供精神关怀具有良好的商业意义。[文章副本收费,可从霍沃斯文件递送服务:1-800-342-9678。电子邮件地址:getinfo@haworthpressinc.com
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引用次数: 29
Physician Attitudes Toward Palliative Care at a Community Teaching Hospital 社区教学医院医生对姑息治疗的态度
Pub Date : 2000-06-01 DOI: 10.1080/0742-969X.2000.11882953
J. Alaeddini, K. Julliard, Ashish Shah, Jamal Islam, Meyer Mayor
ABSTRACT The goals of the study were to explore physicians’ attitudes and opinions about palliative care and its implementation. Four focus groups composed of attending physicians were conducted by a professional facilitator at a community teaching hospital. The audiotapes of the groups were carefully transcribed and analyzed according to rigorous qualitative methodology. Physicians perceived palliative care and pain control as important. Problems they perceived were a lack of education for physicians, residents, other health care professionals, and the general public; a lack of hospital support systems to implement palliative care appropriately, and a lack of knowledge and support regarding legal considerations. They believed that a palliative care unit was a reasonable tool to overcome many obstacles to good end-of-life care. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]
摘要本研究旨在探讨医生对姑息治疗及其实施的态度和意见。在一家社区教学医院,由一名专业调解人主持了由主治医生组成的四个焦点小组。根据严格的定性方法,仔细转录并分析了各组的录音带。医生认为姑息治疗和疼痛控制很重要。他们认为的问题是医生、住院医生、其他卫生保健专业人员和公众缺乏教育;缺乏适当实施姑息治疗的医院支持系统,以及缺乏有关法律考虑的知识和支持。他们认为,姑息治疗单位是一种合理的工具,可以克服许多障碍,实现良好的临终关怀。[文章副本收费,可从霍沃斯文件递送服务:1-800-342-9678。电子邮件地址:getinfo@haworthpressinc.com
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引用次数: 12
Predictors of Family Members’ Satisfaction with Hospice 家庭成员安宁疗护满意度之预测因子
Pub Date : 2000-06-01 DOI: 10.1080/0742-969X.2000.11882951
S. Nolen-Hoeksema, J. Larson, Michael Bishop
ABSTRACT This large, long-term study of families served by hospice found that nearly 95 percent said hospice had been helpful. Still, about 30 percent of family members said there was something they wish hospice had done differently. Those who had some complaint were more likely than those who had no complaints to be women, to report the patient had needed a great deal of care, to have a history of depression and greater levels of distress before and after the patient’s death, and to be dissatisfied with the support they received from family members and friends. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]
这项针对接受安宁疗护服务家庭的大型长期研究发现,近95%的家庭表示安宁疗护有帮助。尽管如此,大约30%的家庭成员表示,他们希望临终关怀医院能做一些不同的事情。那些有一些抱怨的人比那些没有抱怨的人更有可能是女性,报告病人需要大量的照顾,有抑郁史,病人死前和死后的痛苦程度更大,并且对他们从家人和朋友那里得到的支持不满意。[文章副本收费,可从霍沃斯文件递送服务:1-800-342-9678。电子邮件地址:getinfo@haworthpressinc.com
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引用次数: 22
Assessing Readiness for Death in Hospice Elders and Older Adults 评估安宁疗护长者及长者对死亡的准备程度
Pub Date : 2000-06-01 DOI: 10.1080/0742-969X.2000.11882952
L. Moody, Theresa M. Beckie, Charlene Long, Allison Edmonds, Stephanie Andrews
ABSTRACT Background: Readiness for death may affect the quality of the death experience and influence response to treatments. The psychologic vulnerability of the dying person is a major focus of palliative care. Accurate assessment of readiness for death may lead to earlier and more appropriate interventions. Objective: The purpose of this study was to assess the psychometric properties of the revised readiness for death instrument. Methods: Using a known groups technique and a cross-sectional study design, the revised instrument was administered to 52 elders in hospice care with a terminal diagnosis and 91 community dwelling adults without a terminal diagnosis. Results: Instrument content validity (Kappa = 0.96) was supported by three expert panelists who were hospice researchers. Principal components factor analysis explained 43% of the variance and partially supported the proposed four-factor structure of the revised 26-item instrument. Internal consistency was acceptable (.76). Discriminant validity was significant as assessed by an independent t-test between two contrast groups (t = 5.98, p = 0.000). The factor analysis, reliability testing, and qualitative analysis of items supported deletion of 2 items. Conclusions: Results indicated that the revised instrument has sound psychometric properties but further testing with a larger sample of hospice subjects is needed to confirm the factor structure of the instrument. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]
背景:死亡准备可能影响死亡体验的质量和对治疗的反应。临终者的心理脆弱性是姑息治疗的一个主要焦点。对死亡准备程度的准确评估可能导致更早和更适当的干预。目的:本研究的目的是评估修订后的死亡准备程度量表的心理测量特性。方法:采用已知的群体技术和横断面研究设计,对52名临终关怀老人和91名非临终诊断的社区居住成年人进行了改进的工具。结果:量表内容效度(Kappa = 0.96)得到三位安宁疗护研究专家小组成员的支持。主成分因子分析解释了43%的方差,并部分支持修订后的26项工具的拟议四因素结构。内部一致性可接受(0.76)。经独立t检验,两组间判别效度显著(t = 5.98, p = 0.000)。因子分析、信度检验、质性分析均支持删除2项。结论:修订后的量表具有良好的心理测量特性,但需要进一步以更大样本的安宁疗护被试来确认量表的因素结构。[文章副本收费,可从霍沃斯文件递送服务:1-800-342-9678。电子邮件地址:getinfo@haworthpressinc.com
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引用次数: 9
Matching bereavement services to level of need. 根据需要提供相应的丧亲服务。
Pub Date : 2000-01-01 DOI: 10.1080/0742-969x.2000.11882948
K Walsh-Burke

The establishment of hospices in the U.S. has resulted in an increase in bereavement services available to clients experiencing loss. Many of these services, such as educational and peer support groups, are provided without screening or assessment of risk for complicated bereavement in the individuals who utilize them. While acceptance of uncomplicated bereavement is important, assessment for complicated bereavement is also important to ensure that appropriate services are offered to those at risk for problematic adjustment. This article reviews the literature on risk criteria for complicated bereavement and proposes a method both for assessing risk and matching service to level of need, based on these criteria.

在美国,临终关怀医院的建立增加了为经历损失的客户提供的丧亲服务。许多此类服务,如教育和同伴支持小组,在提供时没有对使用这些服务的个人进行复杂丧亲风险的筛查或评估。虽然接受不复杂的丧亲之痛很重要,但对复杂丧亲之痛进行评估也很重要,以确保向有问题调整风险的人提供适当的服务。本文回顾了有关复杂丧亲风险标准的文献,并提出了一种基于这些标准的评估风险和匹配服务水平的方法。
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引用次数: 16
Cost, quality, and satisfaction with hospice after-hours care. 成本、品质与安宁疗护的满意度。
Pub Date : 2000-01-01 DOI: 10.1080/0742-969x.2000.11882944
K Fontaine, R Rositani

Three hundred seventy-three patients enrolled in a health maintenance organization's hospice program were given two different models of after-hours nursing care, one using nurse employees and the other using contract nurses. Statistically significant differences were found between the two groups in cost, in quality of nursing care, and in patient/family satisfaction. Cost of hospital days for the organization was less when patients received after-hours care from nurse employees of the organization, and quality of documentation was better. More patients who received care from nurse employees were satisfied with nurses' arrival time and understanding of problems as well as with the service, information, courtesy, follow-up, and respect which patients received during their hospice stay.

373名病人参加了一家健康维护组织的临终关怀项目,他们得到了两种不同的下班后护理模式,一种是雇佣护士,另一种是雇佣合同护士。两组在护理费用、护理质量和患者/家属满意度方面存在统计学差异。当患者接受该组织护士员工的下班后护理时,该组织的住院日成本较低,并且文件质量较好。更多接受护士员工照顾的病人,对护士的到达时间、对问题的理解,以及病人在安宁疗护期间所得到的服务、资讯、礼貌、跟进和尊重感到满意。
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引用次数: 13
The role of primary caregiver denial in inpatient placement during home hospice care. 家庭安宁疗护期间,主要照护者拒绝在住院病人安置中的作用。
Pub Date : 2000-01-01 DOI: 10.1080/0742-969x.2000.11882945
D J Reese

This study conducted with a sample of 68 home hospice patients revealed that primary caregivers in denial of the patient's terminality were more likely to place hospice patients in inpatient treatment. Moreover, patients placed in inpatient settings were more likely to die there, rather than at home as planned. These findings suggest an impact of primary caregiver denial upon patient self-determination, and indicate the importance of addressing denial in counseling with primary caregivers of terminally ill patients.

本研究以68位居家安宁疗护病人为样本,发现否认病人临终的主要照护者,更有可能让安宁疗护病人住院治疗。此外,住院病人更有可能死在那里,而不是按计划死在家里。这些研究结果表明,主要照顾者的否认对患者的自我决定的影响,并表明在咨询终末期病人的主要照顾者解决否认的重要性。
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引用次数: 11
The evolution of volunteerism and professional staff within hospice care in North Carolina. 北卡罗来纳州临终关怀中志愿服务和专业人员的演变。
Pub Date : 2000-01-01 DOI: 10.1080/0742-969x.2000.11882946
K E Steinhauser, G L Maddox, J L Person, J A Tulsky

Although the pursuit of Medicare certification has been one of the most controversial events in hospice history no study has examined its impact using data from a defined population of hospices before, during, and after federal legislation was enacted. This paper revisits the debate over the changing role of volunteers using such a longitudinal data source. Over time, as the patient population grew, aggregate levels of volunteers and professional staff increased. However, the ratios of professional staff and volunteers to patients reveal that regardless of certification status, hospices retained more professional staff per patient and fewer volunteers per patient over time. These data suggest hospices, particularly certified organizations, have transitioned from voluntary organizations to professionally staffed organizations with a strong volunteer component. The most important issue for future research is whether the observed changes have affected the quality of hospice care.

尽管追求医疗保险认证一直是临终关怀历史上最具争议的事件之一,但没有研究使用联邦立法颁布之前,期间和之后的临终关怀人群的数据来检查其影响。本文回顾了关于使用这种纵向数据源的志愿者角色变化的争论。随着时间的推移,随着患者人数的增加,志愿者和专业人员的总水平也在提高。然而,专业人员和志愿者与患者的比例表明,无论认证状态如何,随着时间的推移,安宁疗护所每名患者保留的专业人员更多,每名患者保留的志愿者更少。这些数据表明,临终关怀,特别是认证组织,已经从志愿组织过渡到专业人员组成的组织,具有很强的志愿组成部分。未来研究最重要的问题是观察到的改变是否会影响安宁疗护的品质。
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引用次数: 2
Nurses' work in a hospice and in an oncological unit in Sweden. 护士在瑞典的临终关怀医院和肿瘤科工作。
Pub Date : 2000-01-01 DOI: 10.1080/0742-969x.2000.11882947
B H Rasmussen, P O Sandman

This paper presents the results of a work-sampling study aimed at describing and comparing the activities of nurses at a free-standing in-patient hospice and a hospital oncological unit. Data suggests that although patient care at both sites is structured by organizational routines, the content and quantity of the nurses' physical and emotional labor differed markedly. Hospice nurses spend significantly more of their working time with patients and/or relatives (37%) than the oncological nurses (21%). When they are with patients the nurses in both settings are most often performing a physical activity such as helping patients with their daily activities in the hospice, and helping patients with needs in relation to investigations and treatment in the oncological unit.

本文提出了一项工作抽样研究的结果,旨在描述和比较护士在独立住院安宁疗护和医院肿瘤单位的活动。数据显示,虽然两个地点的病人护理都是按照组织惯例进行的,但护士的体力劳动和情绪劳动的内容和数量却有显著差异。安宁疗护护士与病人及/或亲属相处的时间(37%)明显多于肿瘤科护士(21%)。当护士和病人在一起时,这两种环境中的护士通常会进行身体活动,例如帮助病人在临终关怀中进行日常活动,并帮助病人满足与肿瘤单位的调查和治疗相关的需求。
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引用次数: 7
The moment of death: is hospice making a difference? 死亡时刻:临终关怀有什么不同吗?
Pub Date : 1999-11-09 DOI: 10.1080/0742-969X.1999.11882943
R. Kastenbaum
The moment of death was a compelling image and dominant concept through much of history. In recent years this term has become destabilized by technological advances and changes in clinical practice. Perhaps even more significantly, the meanings previously associated with the death-bed scene and the final breath have become increasingly marginalized. Hospice programs continue to demonstrate that enlightened and dedicated care can markedly reduce the suffering of terminally ill people and their families. The vast experience acquired by hospice programs, however, has not yet been translated into a vision of the moment of death and the death-bed scene for our times. Several reasons are identified for the limited interest and even more limited hospice-based research into the death-bed scene and the moment of death. Hospice programs could contribute much to our understanding of the final moments of life if this should ever become a priority.
在历史的大部分时间里,死亡时刻是一个引人注目的形象和主导概念。近年来,由于技术进步和临床实践的变化,这个术语变得不稳定。也许更重要的是,以前与死亡之床场景和最后一口气相关的含义已经越来越边缘化。临终关怀计划继续证明,开明和专注的护理可以显著减少绝症患者及其家人的痛苦。然而,临终关怀项目获得的丰富经验尚未转化为我们这个时代对死亡时刻和死亡病床场景的愿景。对死亡病床场景和死亡时刻的研究兴趣有限,甚至更有限,原因有几个。如果临终关怀项目成为优先事项的话,它将有助于我们理解生命的最后时刻。
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引用次数: 11
期刊
The Hospice journal
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