Sukhvir Kaur, Kathleen Boström, Anneke Ullrich, Nikolas Oubaid, Karin Oechsle, Holger Schulz, Raymond Voltz, Kerstin Kremeike
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Sociodemographic data were analysed descriptively, and responses were analysed using qualitative thematic analysis. <i>Results</i>. Of <i>n</i> = 65 experts, 52% work as nursing staff and 30% as physicians. We identified facilitators, barriers, and needs for improvement regarding 11 topics on the following three levels: institutional level (general institutional conditions, hospital culture, and integration of specialist palliative care), team level (attitude towards and dealing with death and dying, competencies, communication, and teamwork) and care level (dying phase, symptom control, patient centredness, and involvement of informal caregivers). <i>Conclusion</i>. Improving care in the dying phase has to overcome barriers on various levels. 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引用次数: 0
摘要
导言。在全球范围内,医院是临终关怀的重要场所,也是德国最常见的死亡场所(47%),但同时却是病人及其非正式护理人员最不愿意去的地方。由于很少对医院非姑息治疗病房的临终关怀进行系统研究,我们首先对医院临终关怀的现状进行了评估。调查方法在一项在线调查中,我们邀请了 N = 165 位国家卫生专家回答 8 个开放性问题,内容涉及临终关怀的护理方面、促进因素、障碍、改进需求以及 COVID-19 大流行的具体情况。对社会人口学数据进行了描述性分析,并采用定性主题分析法对回答进行了分析。结果。在 n = 65 位专家中,52% 为护理人员,30% 为医生。我们就以下三个层面的 11 个主题确定了促进因素、障碍和改进需求:机构层面(总体机构条件、医院文化和整合专科姑息关怀)、团队层面(对待和处理死亡和临终的态度、能力、沟通和团队合作)和护理层面(临终阶段、症状控制、患者中心和非正式护理人员的参与)。结论改善临终关怀必须克服各个层面的障碍。我们认为,一些 "微小 "的措施将被纳入临床常规,并有助于改善临终阶段的医院护理。
Health Experts’ Perspectives on Barriers, Facilitators, and Needs for Improvement of Hospital Care in the Dying Phase
Introduction. Globally, hospitals are an important place in end-of-life care and most frequent place of death in Germany (47%), but at the same time, the least preferred one—both for patients and their informal caregivers. As hospital care in the dying phase on non-palliative care wards has rarely been studied systematically, we assessed the current state of care in the dying phase in hospitals as a first step. Methods. In an online survey, N = 165 national health experts were invited to answer eight open questions on care aspects, facilitators, barriers, and needs for improvement as well as COVID-19 pandemic specifics regarding hospital care in the dying phase. Sociodemographic data were analysed descriptively, and responses were analysed using qualitative thematic analysis. Results. Of n = 65 experts, 52% work as nursing staff and 30% as physicians. We identified facilitators, barriers, and needs for improvement regarding 11 topics on the following three levels: institutional level (general institutional conditions, hospital culture, and integration of specialist palliative care), team level (attitude towards and dealing with death and dying, competencies, communication, and teamwork) and care level (dying phase, symptom control, patient centredness, and involvement of informal caregivers). Conclusion. Improving care in the dying phase has to overcome barriers on various levels. We assume that rather “small” measures will find their way into clinical routine and contribute to the improvement of hospital care in the dying phase.
期刊介绍:
IJCP is a general medical journal. IJCP gives special priority to work that has international appeal.
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