School of Social Work, Columbia University, New York, New York 10027, USA.
J Palliat Med. 2010 Mar;13(3):267-71. doi: 10.1089/jpm.2009.0281.
Reports in the end-of-life literature reveal that patients and health care professionals, including social workers, nurses, and physicians, avoid discussions about preparation for such care. End-of-life care discussion barriers include, but are not limited to, professionals feeling unprepared to have the discussions and patients' lack of readiness to discuss planning for this care. Another barrier is the lack of a structured framework to initiate these discussions, especially with clients with advanced illnesses who may not acknowledge that they are at high risk for needing end-of-life care in the future. In a controlled trial of an Advanced Illness Coordinated Care Program, social workers initiated end-of-life planning discussions using the Stages of Change model (SOC). This article describes how the social workers introduced end-of-life planning discussions using the SOC conceptual structure to illustrate the application of a conceptual framework for professionals working with advanced illness populations.
在生命末期文献中报告显示，患者和医疗保健专业人员（包括社会工作者、护士和医生）避免讨论此类护理的准备工作。生命末期护理讨论的障碍包括但不限于专业人员觉得没有准备好进行讨论以及患者缺乏准备来讨论这种护理的规划。另一个障碍是缺乏启动这些讨论的结构化框架，特别是对于患有晚期疾病的患者，他们可能不承认他们将来有需要生命末期护理的高风险。在一项使用变化阶段模型（SOC）的晚期疾病协调护理计划的对照试验中，社会工作者使用 SOC 启动了生命末期规划讨论。本文描述了社会工作者如何使用 SOC 概念结构引入生命末期规划讨论，以说明为晚期疾病患者提供服务的专业人员应用概念框架的情况。
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