Powers Bethel Ann, Norton Sally A, Schmitt Madeline H, Quill Timothy E, Metzger Maureen
School of Nursing, University of Rochester, 601 Elmwood Avenue, Box SON, Rochester, NY 14642, USA.
J Aging Res. 2011 Apr 13;2011:406164. doi: 10.4061/2011/406164.
Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of four practice paradigms (EOL transitions, prognostic uncertainty, discharge planning, and patient/family values and preferences) and identification of the underlying structure and communication patterns of PC consultation services common to them. Conclusions. Consistent with reports by other researchers, study data support the need to move beyond equating PC with hospice or EOL care and the notion that EOL is a well-demarcated period of time before death. If professional health care providers assume that PC services are limited to assisting with and helping patients and families prepare for dying, they miss opportunities to provide care considered important to older individuals confronting life-limiting illnesses.
目的。通过一项针对急性护理医院姑息治疗咨询服务的为期四年的人种学研究中以案例为中心的老年患者数据示例，来说明姑息治疗（PC）与临终（EOL）服务的区别与交叉。方法。定性叙事和主题分析。结果。描述了四种实践模式（临终过渡、预后不确定性、出院计划以及患者/家庭价值观和偏好），并确定了它们共有的姑息治疗咨询服务的潜在结构和沟通模式。结论。与其他研究人员的报告一致，研究数据支持有必要超越将姑息治疗等同于临终关怀或临终护理的观念，以及临终是死亡前一个界限分明的时间段的观念。如果专业医疗服务提供者认为姑息治疗服务仅限于协助并帮助患者及其家人为死亡做准备，那么他们就会错过为面临生命有限疾病的老年人提供被认为重要的护理的机会。
