Kealey P, McIntyre I
Palliative Care, Iveagh Buildings, Belfast BT12 6HF, UK.
Eur J Cancer Care (Engl). 2005 Jul;14(3):232-43. doi: 10.1111/j.1365-2354.2005.00559.x.
In the past 20 years there has been considerable growth in the provision of palliative care services. The shift in emphasis from hospice and hospital care to the development of community services has been significant. This enables people to be cared for at home and is in keeping with Government agenda. While this may be beneficial for the patient and fit in with the wishes of the family, it is likely to put heavy demands on the coping resources of individual carers. The views of service users are of paramount importance when discussing service evaluation and patient, family and carer empowerment. This research presents the findings of an evaluation of the domiciliary occupational therapy service provided for patients in the palliative stage of cancer care in North and West Belfast from the perspective of the patients and carers. For the purpose of this study, the palliative stage of cancer care is defined as the point from which the patient is no longer responsive to curative treatment, until death. A sample of 30 patients and their primary informal carers were selected using purposive sampling. A structured interview was carried out with both the patients and their carers to obtain views. Results suggest that although both patients and their carers value the service provided and report high levels of satisfaction, there are gaps identified in service provision and a lack of clear information among patients and their carers about the role of the occupational therapist and the range of services they can provide. There is a need to build upon the good work being done by domiciliary occupational therapists in the area of palliative cancer care and increase education and resources to ensure that a patient-centred, holistic, approach to care is used, addressing both the needs of the patient and their carers.
在过去20年里，姑息治疗服务的提供有了显著增长。重点从临终关怀和医院护理转向社区服务的发展，这一转变意义重大。这使人们能够在家中得到照料，符合政府议程。虽然这可能对患者有益且符合家庭意愿，但可能会给个体护理人员的应对资源带来沉重负担。在讨论服务评估以及患者、家庭和护理人员赋权时，服务使用者的观点至关重要。本研究从患者和护理人员的角度，呈现了对北贝尔法斯特和西贝尔法斯特为处于癌症护理姑息阶段的患者提供的居家职业治疗服务的评估结果。在本研究中，癌症护理的姑息阶段被定义为患者不再对治愈性治疗有反应直至死亡的阶段。采用目的抽样法选取了30名患者及其主要非正式护理人员作为样本。对患者及其护理人员都进行了结构化访谈以获取意见。结果表明，尽管患者及其护理人员都重视所提供的服务并报告了较高的满意度，但在服务提供方面存在差距，患者及其护理人员对职业治疗师的角色以及他们所能提供的服务范围缺乏明确信息。有必要在居家职业治疗师在姑息性癌症护理领域所做的出色工作基础上再接再厉，增加教育和资源，以确保采用以患者为中心的整体护理方法，满足患者及其护理人员的需求。
