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Attitudes toward assisted suicide: a survey of hospice volunteers. 临终关怀志工对协助自杀的态度调查。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882920
P W Zehnder, D Royse

Technological advances have lengthened our years and, often, the dying process as well. While studies have been conducted of physicians and dying patients concerning their views on assisted suicide, no prior studies have examined the attitudes of hospice volunteers. This survey of 277 hospice volunteers found that overall their attitudes were more supportive of assisted suicide than that of a convenience sample of the public. Thirty-seven percent of the volunteers endorsed the view that there are situations when assisting death may be morally acceptable; 4% had been asked to provide assistance to help a patient end his or her life.

科技进步延长了我们的寿命,也延长了我们的死亡过程。虽然有关于医生和临终病人对协助自杀的看法的研究,但之前没有研究调查过临终关怀志愿者的态度。这项对277名临终关怀志愿者的调查发现,总的来说,他们的态度比方便抽样的公众更支持协助自杀。37%的志愿者认为在某些情况下协助死亡在道德上是可以接受的;4%曾被要求协助病人结束生命。
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引用次数: 9
Hospice care for injection drug using AIDS patients. 注射吸毒艾滋病患者的临终关怀。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882911
C Cox

Injection drug use now accounts for the majority of new AIDS cases. Treatment for these patients is both more complex and more costly than for other AIDS patients as the factors associated with drug use are obstacles to treatment. Using data from a national survey of hospices, the findings from this study indicated that resources, hospice size, years in operation, and the Medicaid waiver were associated with hospice involvement with these patients. Staff training and supports are important factors in adequately dealing with the issues that these patients present.

注射吸毒现在占艾滋病新病例的大多数。与其他艾滋病患者相比,对这些患者的治疗既复杂又昂贵,因为与吸毒有关的因素是治疗的障碍。本研究使用一项全国性的安宁疗护调查资料,结果显示资源、安宁疗护规模、营运年数、以及医疗补助豁免与病患参与安宁疗护有关。员工培训和支持是充分处理这些患者所面临问题的重要因素。
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引用次数: 5
New initiatives transforming hospice care. 改变临终关怀的新举措。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969X.1999.11882938
S. Connor
Hospice care has been successful in serving a large segment of the terminally ill population in the United States. This article addresses a number of significant trends that may impact the future of hospice care. It is proposed that as many as one-third of those who die will not be in a position to make use of any end-stage program of care. Of the remaining, some will have difficulty being served by hospices due to uncertain prognosis and continued efforts at curative treatment. New models of caring for chronically terminally ill persons are being developed and are reviewed. A clearer definition of who ought to be served by hospice programs is encouraged.
在美国,临终关怀已经成功地服务了很大一部分绝症患者。本文讨论了一些可能影响临终关怀未来的重要趋势。据建议,多达三分之一的死者将无法利用任何终末期护理方案。在剩下的人中,由于预后不确定和持续的治疗努力,一些人将难以得到安宁疗护所的服务。正在开发和审查照顾慢性绝症患者的新模式。鼓励对临终关怀项目应该为谁服务有一个更清晰的定义。
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引用次数: 12
Reflections on death in America. 美国人对死亡的思考
Pub Date : 1999-01-01 DOI: 10.1080/0742-969X.1999.11882939
G. Soros
The project on Death in America was established to promote a better understanding of the experience of dying and bereavement and by doing so help transform the culture surrounding death. The Faculty Scholars Program provides three year fellowships for projects that explore critical aspects of the care of the dying, for those who will become academic leaders on the issue, as well as, role models and mentors to future generations of health professionals. A Grants Program broad enough to cover every aspect of the culture of dying allocates funding for innovative projects. A new grants program is underway to support projects aimed at enhancing the role of the humanities in transforming the culture of death and dying in America.
美国死亡项目的建立是为了促进对死亡和丧亲之痛的体验的更好理解,并通过这样做帮助改变围绕死亡的文化。学院学者计划为那些探索临终关怀关键方面的项目提供三年的奖学金,这些项目将成为该问题的学术领袖,以及未来几代卫生专业人员的榜样和导师。一个足以涵盖死亡文化各个方面的资助计划为创新项目分配资金。一项新的拨款计划正在进行中,以支持旨在加强人文学科在改变美国死亡文化和临终文化中的作用的项目。
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引用次数: 5
Balancing the focus: art and music therapy for pain control and symptom management in hospice care. 平衡焦点:艺术和音乐治疗在临终关怀中的疼痛控制和症状管理。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882912
B Trauger-Querry, K R Haghighi

Pain and symptom management are a major part of hospice care. Literature and direct experience suggest that pain can be resistant if psychological, emotional, or spiritual issues are not addressed. This article explains how art and music therapies can work in conjunction with traditional medical treatment of pain control in the hospice setting. The process of pain modulation through the use of art and music interventions is diagrammed and described. Brief clinical examples demonstrate the use of art and music therapies for pain reduction with a variety of hospice patients. Information regarding appropriate education and training necessary for art and music therapists to practice in their field is presented.

疼痛和症状管理是临终关怀的主要部分。文献和直接经验表明,如果心理、情感或精神问题没有得到解决,疼痛是可以抵抗的。这篇文章解释了艺术和音乐疗法如何在临终关怀环境中与传统的疼痛控制医学治疗相结合。通过使用艺术和音乐干预疼痛调节的过程是图表和描述。简短的临床例子展示了使用艺术和音乐疗法来减轻各种临终关怀病人的疼痛。介绍了艺术和音乐治疗师在其领域实践所需的适当教育和培训的信息。
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引用次数: 51
Analysis of Texas & New Mexico Hospice Organization's new Code of Ethics. 德克萨斯州和新墨西哥州临终关怀组织新道德准则分析。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882914
M J Smith

Unique among professional codes of ethics is the Texas & New Mexico Hospice Organization's Code of Ethics. Where other codes concentrate only on principles-based ethics, this new code identifies five models of bioethics currently used in resolving ethical dilemmas. This report's primary purpose analyzes the code's four precepts in the context of (1) principles-based ethics, (2) casuistic-based ethics, (3) covenant-based ethics, (4) evidence-based ethics and narrative-based ethics. The second purpose is to present the practicality of these often esoteric concepts in the day-to-day work of palliative care providers. Indications are that this code of ethics, because of its broad scope, is more useful than other principles-based-only codes.

在职业道德规范中,独特的是德克萨斯州和新墨西哥州临终关怀组织的道德规范。其他准则只关注基于原则的伦理,而这一新准则则确定了目前用于解决伦理困境的五种生物伦理模型。本报告的主要目的是在以下几个方面分析《准则》的四个戒律:(1)基于原则的伦理,(2)基于诡辩的伦理,(3)基于契约的伦理,(4)基于证据的伦理和基于叙述的伦理。第二个目的是在缓和治疗提供者的日常工作中呈现这些通常深奥的概念的实用性。有迹象表明,这一道德守则由于其范围广泛,比其他仅以原则为基础的守则更有用。
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引用次数: 0
Hospice Care and Palliative Care 临终关怀和姑息治疗
Pub Date : 1999-01-01 DOI: 10.1300/j011v14n03_12
P. Brenner
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引用次数: 1
Do Medicare HMOs and Medicare FFS differ in their use of the Medicare hospice benefit? 医疗保险hmo和医疗保险FFS在使用医疗保险临终关怀福利方面有不同吗?
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882910
B A Virnig, N A Persily, R O Morgan, C A DeVito

This study compares use of the hospice benefit in Medicare fee-for-service (FFS) and Medicare risk-health maintenance organization (HMO) options in South Florida in 1992. A higher percentage of deaths occurred in hospice in the HMO option than in the FFS option. Compared to individuals in the FFS option, HMO-enrolled hospice users had longer lengths of hospice stay, lower 7-day mortality and higher 180-day (6 month) survival. These differences are consistent with the physician's financial incentives associated with the two programs.

本研究比较1992年南佛罗里达州医疗保险按服务收费(FFS)与医疗保险风险健康维持组织(HMO)方案中安宁疗护福利的使用情况。HMO选择的临终关怀死亡比例高于FFS选择。与FFS选项的个体相比,hmo登记的安宁疗护使用者的安宁疗护停留时间更长,7天死亡率更低,180天(6个月)存活率更高。这些差异与医生对这两个项目的经济激励是一致的。
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引用次数: 40
Men and women and their responses in spousal bereavement. 男性和女性及其对配偶丧亲的反应。
Pub Date : 1999-01-01 DOI: 10.1080/0742-969x.1999.11882921
D G Quigley, M S Schatz

In this study, the Grief Experience Inventory was used to examine grief responses among men and women associated with a Colorado hospice program. Using this inventory instrument, the findings document a broad range of emotional responses to grief among men and women, yet no significant differences were found. These findings appear to differ from the perceptions of bereavement counselors who often identify behavioral differences in the grief experiences of men and women.

在本研究中,哀伤体验量表被用来检查与科罗拉多州临终关怀计划相关的男性和女性的哀伤反应。使用这个清单工具,研究结果记录了男性和女性对悲伤的广泛情绪反应,但没有发现显著差异。这些发现似乎与丧亲咨询师的看法不同,他们经常识别男性和女性在悲伤经历中的行为差异。
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引用次数: 13
Hospice care and palliative care: a perspective from experience. 临终关怀与缓和疗护:从经验的角度。
Pub Date : 1999-01-01
P R Brenner

The establishment of the first Department of Pain Medicine and Palliative Care in a Medical Center in the United States is noteworthy. Since the design of the Department integrates a full-functioning hospice program within it, that has both a dedicated inpatient unit and extensive home care program, this Department represents a milestone in the development of the hospice movement, with full interrelationship between palliative care and hospice care. This paper will explore this interrelationship, its implications, and some of the background.

值得注意的是,在美国的医疗中心建立了第一个疼痛医学和姑息治疗部门。由于该部门的设计整合了一个功能齐全的临终关怀计划,其中既有专门的住院病房,也有广泛的家庭护理计划,该部门代表了临终关怀运动发展的一个里程碑,在姑息治疗和临终关怀之间建立了充分的相互关系。本文将探讨这种相互关系,其含义,以及一些背景。
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引用次数: 0
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The Hospice journal
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