The Swedish Institute For Health Sciences, Lund University, Sweden.
Int J Nurs Stud. 2012 Apr;49(4):455-64. doi: 10.1016/j.ijnurstu.2011.10.016. Epub 2011 Nov 12.
Palliative care should be provided, irrespective of setting to all patients facing a life-threatening illness and to their families. The situation and needs of older people differ from those of younger people since they often have several co-existing diseases and health complaints. This implies an extensive need for care and for longer periods of palliative care. The main providers of palliative care for older people are nurse assistants, who are also those with the shortest education.
The aim of this study was to illuminate nurse assistants' experience of palliative care for older people in residential care.
The study had an explorative, descriptive design.
Thirteen residential care units in three different districts in a large city in southern Sweden.
Twenty-five nurse assistants selected to represent variations in age, gender workplace and work experience.
Data were collected from six focus-group interviews and subjected to content analysis to gain an understanding of the phenomenon.
The nurse assistants described palliative care as a contrast to the everyday care they performed in that they had a legitimate possibility to provide the care needed and a clear assignment in relation to relatives. Palliative care also meant having to face death and dying while feeling simultaneous that it was unnatural to talk about death and having to deal with their own emotions. They emphasised that they were in need of support and experienced leadership as invisible and opaque, but gained strength from being recognized.
In order to support nurse assistants in providing high quality end-of-life care, more focus is needed on the trajectory of older peoples' dying, on the importance of involving relatives throughout the period of care provision, and on support when encountering death and dying. There is also a need for engaged care leaders, both registered nurses and managers, to recognize the work of nurse assistants and to support care provision for older people within the framework of palliative care philosophy.
姑息治疗应提供，无论设置为所有面临危及生命的疾病和他们的家庭的患者。老年人的情况和需求与年轻人不同，因为他们往往有几种并存的疾病和健康问题。这意味着需要广泛的护理和更长时间的姑息治疗。老年人姑息治疗的主要提供者是护士助理，他们也是接受教育时间最短的人。
本研究旨在阐明护士助理在老年人居住护理中提供姑息治疗的经验。
本研究具有探索性和描述性设计。
瑞典南部一个大城市的三个不同地区的 13 个居住护理单位。
25 名护士助理，代表了年龄、性别、工作场所和工作经验的差异。
从六次焦点小组访谈中收集数据，并进行内容分析，以了解该现象。
护士助理将姑息治疗描述为与他们日常护理的对比，因为他们有合法的可能性提供所需的护理，并与亲属有明确的任务关系。姑息治疗还意味着必须面对死亡和临终，同时感到谈论死亡是不自然的，并且必须处理自己的情绪。他们强调，他们需要支持，并感到领导是无形和不透明的，但从被认可中获得力量。
为了支持护士助理提供高质量的临终关怀，需要更加关注老年人临终的轨迹，重视在整个护理提供期间让亲属参与的重要性，以及在遇到死亡和临终时提供支持。还需要有敬业的护理领导者，包括注册护士和管理人员，认可护士助理的工作，并在姑息治疗理念框架内支持老年人的护理提供。
