Education and Research Unit, Arohanui Hospice, Palmerston North, New Zealand.
J Palliat Med. 2011 Jun;14(6):688-95. doi: 10.1089/jpm.2010.0471. Epub 2011 Apr 15.
Increasingly, aged residential care (ARC) facilities are places where the lives of older people with complex care needs end. Hence, end-of-life (EOL) care is a significant component of work for ARC staff. In the absence of New Zealand research, staff perceptions of EOL care were sought at three aged-care facilities in a New Zealand District Health Board region. The research provided valuable data regarding care delivery and can be used to inform the introduction of an integrated care pathway (ICP). EOL care pathways are not commonly used in New Zealand ARC facilities and the influence of ICPs, such as the Liverpool Care Pathway (LCP) for the dying patient has not been investigated. Additionally, most international studies report on the introduction of the LCP without baseline preimplementation data.
In the present study, staff (n = 195) involved in caring for residents, their families, and whānau at EOL were surveyed to obtain demographic data and staff perceptions of EOL care via Likert scale and open ended questions.
A response rate of 32% was obtained. Respondents indicated a relatively high level of confidence regarding their care of the dying, including aspects of communication, teamwork and use of documentation. However, this was often contradicted by their written responses. Written comments were analyzed thematically and six themes identified: the naturalness of dying; the character of care; care relationships; emotional response; knowledge; and the organizational environment. Data analysis provided a rich and informative description of staff perceptions of EOL and issues influencing care.
越来越多的老年人居住护理（ARC）设施成为了生活不能自理的老年人生命终结的地方。因此，临终关怀（EOL）是 ARC 工作人员的重要工作内容之一。在新西兰缺乏相关研究的情况下，研究人员在新西兰地区卫生委员会的三个老年人护理机构中调查了工作人员对 EOL 护理的看法。该研究提供了有关护理服务的宝贵数据，可用于为引入综合护理途径（ICP）提供信息。EOL 护理途径在新西兰的 ARC 设施中并不常用，也没有研究过 ICP 的影响，例如临终患者的利物浦护理途径（LCP）。此外，大多数国际研究报告了 LCP 的引入，而没有实施前的基线数据。
在本研究中，对临终时参与护理居民、他们的家人和 whānau（毛利语，指代家族或社群）的工作人员（n=195）进行了调查，以通过李克特量表和开放式问题获得人口统计学数据和工作人员对 EOL 护理的看法。
获得了 32%的回复率。受访者表示对他们临终关怀的信心相对较高，包括沟通、团队合作和使用文件记录等方面。然而，这往往与他们的书面回答相矛盾。书面评论进行了主题分析，确定了六个主题：死亡的自然性；护理的特点；护理关系；情绪反应；知识；和组织环境。数据分析提供了工作人员对 EOL 看法和影响护理的问题的丰富而有启发性的描述。
