Ferrell B R, Cohen M Z, Rhiner M, Rozek A
City of Hope National Medical Center, Duarte, CA.
Oncol Nurs Forum. 1991 Nov-Dec;18(8):1315-21.
Changes in the healthcare system have made the patient's home the primary site of cancer care. Family members, already burdened with the psychological impact of having a loved one with cancer, take on caregiving roles to meet the multiple and complex needs of the patient. Part I of this two-part article focused on family caregivers' descriptions of the patients' pain and the impact of this pain on caregivers. A model of the Caregiver Experience of Pain is provided along with implications for future inquiry and clinical practice. Themes identified in caregiver roles in medication administration included deciding what to give, deciding when to give, night duty, reminding/encouraging, keeping records, fear of addiction, and doing everything. Caregiver roles in nondrug interventions included positioning/mobility, massage, use of ointments/lotions, cold, heat, being there through touch, avoiding touch, and talk and other distractions. Caregiver perceptions of what doctors or nurses could do better included themes of being there, explain, be honest/listen, addiction concern, and giving medication. Caregiver questions included areas of future, understanding why, death, concern about medications, and fear about what to do at home. The study results offer important suggestions for oncology nurses in supporting family caregivers in the management of the patient in pain.
医疗保健系统的变革已使患者家庭成为癌症护理的主要场所。家庭成员本就因亲人患癌而承受着心理压力，此时又要承担起照顾患者的责任，以满足患者多样且复杂的需求。这篇分两部分的文章的第一部分聚焦于家庭护理人员对患者疼痛的描述以及这种疼痛对护理人员的影响。文中提供了一个疼痛护理人员体验模型，并阐述了其对未来研究和临床实践的启示。在药物管理中护理人员角色所呈现的主题包括决定用药、决定用药时间、夜间值班、提醒/鼓励、记录、担心成瘾以及事事亲为。在非药物干预中护理人员的角色包括体位/活动、按摩、使用药膏/洗剂、冷敷、热敷、通过触摸陪伴、避免触摸以及交谈和其他分散注意力的方式。护理人员对医生或护士可以改进之处的看法包括陪伴、解释、诚实/倾听、关注成瘾问题以及给药方面的主题。护理人员的问题包括未来、理解原因、死亡、对药物的担忧以及对在家中应对措施的恐惧等方面。研究结果为肿瘤护理人员在支持家庭护理人员管理疼痛患者方面提供了重要建议。
