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[临终关怀与濒死患者的尊严。姑息治疗中的定义与支持性干预措施]

[Dignity in the care of terminal ill and dying patients. Definitions and supportive interventions in palliative care].

作者信息

Mehnert A, Schröder A S, Puhlmann K, Müllerleile U, Koch U

机构信息

Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, BRD.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006 Nov;49(11):1087-96. doi: 10.1007/s00103-006-0069-6.

Abstract

Most patients, family members, health care professional as well as volunteers would agree that dignified care and being allowed to die with dignity are superior and unquestionable goals of palliative care. Although the majority of people have a more or less vague concept of dignity and despite its significance for palliative care, only a few empirical approaches to describe the sense of dignity from patients' and health care professionals' perspectives have been undertaken. However, individual descriptions of the dignity concept and definitions can serve as an impetus to improve the current palliative care practice by the development and evaluation of psychotherapeutic interventions for patients near the end of life and the allocation of resources. This article considers an internationally developed empirical-based model of dignity in severe and terminal ill patients by Chochinov et al. Furthermore, it illustrates the understanding of dignity as well as self-perceived exertions of influence on a patient's dignity from the perspective of health care professionals and volunteers. Psychotherapeutic interventions and strategies are introduced that can help conserve the sense of dignity of patients during palliative care.

摘要

大多数患者、家属、医护人员以及志愿者都会认同,尊严照护以及有尊严地离世是姑息治疗的首要且不容置疑的目标。尽管大多数人对尊严或多或少都有一个模糊的概念,并且尊严对姑息治疗很重要,但从患者和医护人员的角度出发,仅有少数实证方法来描述尊严感。然而,对尊严概念和定义的个体描述可以通过为临终患者开发和评估心理治疗干预措施以及资源分配,推动当前姑息治疗实践的改进。本文探讨了乔奇诺夫等人在国际上开发的针对重症和晚期患者的基于实证的尊严模型。此外,它还从医护人员和志愿者的角度阐述了对尊严的理解以及对患者尊严的自我感知影响。文中还介绍了一些心理治疗干预措施和策略,这些措施有助于在姑息治疗期间维护患者的尊严感。

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