Freeman Shanna L, Berger Ann M
Veterans Affairs Medical Center, Omaha, NE, USA.
Clin J Oncol Nurs. 2009 Aug;13(4):399-403. doi: 10.1188/09.CJON.399-403.
More than 1,800 veterans die in a variety of healthcare settings each day, illustrating a need to improve their end-of-life (EOL) care. In 2006, the Nebraska End-of-Life Survey was mailed to 2,713 urban and rural Nebraskan adults' homes; 44 of 324 first-time respondents (14%) were veterans. This article compares survey responses from veterans and nonveterans and discusses four issues: personal desires during the dying process, fear of dying, completion of advance directives, and communication preferences. Compared to nonveterans, veterans were significantly less likely to want friends or family visiting at EOL, less likely to place importance on being at peace spiritually, less afraid of dying alone, more likely to turn to a spouse to initiate EOL conversations, and less trusting of primary physicians on EOL issues. In addition, veterans had higher rates of completion of advance directives. Examining the survey responses can help guide clinical oncology nurses in delivering EOL care to veterans.
每天有超过1800名退伍军人在各种医疗环境中死亡，这表明需要改善他们的临终关怀。2006年，内布拉斯加州临终调查被邮寄到内布拉斯加州2713名城乡成年人的家中；324名首次回复者中有44名（14%）是退伍军人。本文比较了退伍军人和非退伍军人的调查回复，并讨论了四个问题：临终过程中的个人愿望、对死亡的恐惧、预先指示的完成情况以及沟通偏好。与非退伍军人相比，退伍军人在临终时希望朋友或家人探访的可能性显著降低，对精神安宁的重视程度较低，不太害怕孤独地死去，更有可能向配偶发起临终谈话，并且在临终问题上对初级医生的信任度较低。此外，退伍军人预先指示的完成率更高。研究调查回复有助于指导临床肿瘤护士为退伍军人提供临终关怀。
