Goodridge Donna, Duggleby Wendy
College of Nursing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada S7T 5E5.
J Palliat Care. 2010 Autumn;26(3):141-50.
High-quality palliative care may remain out of reach for rural people who are dying. The purpose of this study was to explore the opportunities and issues affecting the provision of high-quality palliative care from the perspective of nurses employed in two rural health regions.
Using an interpretive descriptive design, focus groups and in-depth individual interviews of 44 nurses were conducted.
Descriptions of challenges and opportunities fell into three themes: effectiveness and safety, patient-centredness, and efficiency and timeliness. Patient-centredness was seen as a major strength of rural palliative care. Major challenges included provision of adequate symptom management and support of home deaths. The scarcity of health human resources and the negative impact these shortages had on all dimensions of palliative care quality consistently underpinned the discussions.
Implementing outcome measurements related to symptom management and home deaths may be a critical foundation for enhancing the quality of rural palliative care.
对于濒死的农村居民而言,高质量的姑息治疗可能仍然遥不可及。本研究旨在从两个农村卫生区域的护士视角,探讨影响提供高质量姑息治疗的机遇与问题。
采用诠释性描述设计,对44名护士进行焦点小组访谈和深度个人访谈。
挑战与机遇的描述分为三个主题:有效性与安全性、以患者为中心、效率与及时性。以患者为中心被视为农村姑息治疗的主要优势。主要挑战包括提供充分的症状管理以及支持在家中离世。卫生人力资源的稀缺以及这些短缺对姑息治疗质量各方面产生的负面影响始终贯穿于讨论之中。
实施与症状管理和在家中离世相关的结果测量,可能是提高农村姑息治疗质量的关键基础。