Munn Jean C, Zimmerman Sheryl
School of Social Work, University of North Carolina at Chapel Hill and the Cecil G Sheps Center for Health Services Research, 725 Martin Luther King, Jr Blvd, Campus Box 7590, Chapel Hill, NC 27599-7590, USA.
J Soc Work End Life Palliat Care. 2006;2(3):45-59. doi: 10.1300/J457v02n03_05.
Little research has been done on the topic of end-of-life care in long-term care settings to identify important themes regarding end-of-life care structures, processes, and outcomes. This study utilized data gathered in a stratified, random sample of 437 family members of residents who died in 31 nursing homes (NHs) and 199 residential care/ assisted living facilities. Structural components of care including staffing adequacy, training, and consistency as well as facility environment and size were important factors for family members interviewed. "Being there" and manner of care delivery (e.g., staff attitudes/empathy) were major elements in the process of care. These factors were mentioned more than direct care, Hospice, or resident preferences. Family members identified themes of [dying at] home and being comfortable and clean as important outcomes of care. These identified structural components, processes, and outcomes have implications for the role of social workers in these settings despite that social work support is notably absent in these findings.
关于长期护理机构中的临终关怀主题,目前进行的研究较少,无法确定有关临终关怀结构、流程和结果的重要主题。本研究利用了从31家养老院(NHs)和199家住宅护理/辅助生活设施中死亡居民的437名家庭成员的分层随机样本中收集的数据。护理的结构组成部分,包括人员配备充足、培训和一致性以及设施环境和规模,是接受访谈的家庭成员的重要因素。“陪伴在旁”和护理方式(如工作人员的态度/同理心)是护理过程中的主要因素。这些因素比直接护理、临终关怀或居民偏好被提及得更多。家庭成员将在家中离世、舒适和干净视为护理的重要结果。尽管在这些研究结果中明显缺乏社会工作支持,但这些确定的结构组成部分、流程和结果对社会工作者在这些环境中的角色具有启示意义。