Clark K
Respir Care. 1986 Apr;31(4):329-33.
Placement of the ventilator-dependent patient must take into consideration the psychosocial aspects of the situation. These include the patient's age, level of emotional and cognitive function, financial status, insurance benefits, cultural and personal-experience influences regarding life-threatening illness and institutionalization, and the availability of suitable caregivers. The hospital provides the greatest physical security but is expensive and allows minimal patient autonomy and family involvement. A nursing home is homier and less expensive, but it must have a staff well trained in the complex care of these patients and someone to oversee execution of the care plan, and its cost may not be adequately reimbursed by private insurance. Home care usually provides the best conditions for the patient, but it requires trained and available health professionals; a committed physician; education of the patient, family, and attendants; a suitable residence; a system for delivery and maintenance of supplies and equipment; and dependable financing; and it must allow the patient increased independence, socialization, and activities of daily living. Ventilator-dependent patients commonly experience fear, feelings of total dependency, and even degradation. Caregivers can relieve these feelings by reassuring the patient about safety measures, by keeping him informed about medical procedures, and by establishing communication.
对于依赖呼吸机的患者进行安置时，必须考虑到该情况的社会心理因素。这些因素包括患者的年龄、情绪和认知功能水平、经济状况、保险福利、关于危及生命疾病和住院治疗的文化及个人经历影响，以及合适护理人员的可获得性。医院提供了最大程度的人身安全保障，但费用高昂，且患者的自主权和家庭参与度极低。疗养院更像家且费用较低，但必须有经过复杂护理这些患者培训的工作人员以及监督护理计划执行的人员，而且其费用可能无法得到私人保险的充分报销。居家护理通常为患者提供最佳条件，但需要有经过培训且随时可用的健康专业人员、一位尽责的医生、对患者、家属和护理人员的教育、合适的住所、供应品和设备的配送及维护系统以及可靠的资金；并且必须给予患者更多的独立性、社交机会和日常生活活动能力。依赖呼吸机的患者通常会经历恐惧、完全依赖感甚至尊严丧失。护理人员可以通过向患者保证安全措施、让其了解医疗程序以及建立沟通来缓解这些感受。
