Saiseikai Central Hospital, Nursing Department, Minato-ku, Tokyo, Japan.
Palliat Support Care. 2013 Oct;11(5):405-13. doi: 10.1017/S1478951512000442. Epub 2012 Jul 6.
One of the most important goals of palliative care is achieving a good death. Most Japanese believe that “having some pleasure in daily life” is necessary at the end of life. The aim of this study was to identify, from the perspective of physicians and nurses, a care strategy that ensures that cancer patients have pleasure in daily life at the end of life.
We conducted semistructured interviews with experts in palliative care units. A total of 45 participants included 22 palliative care physicians and 23 nurses. Transcripts of the interviews were analyzed using a content analysis method.
Care for end-of-life cancer patients that ensures they have some pleasure in daily life was classified into five categories: “Pain assessment and pain easing” aimed to offer physical and psychological pain assessment and relief. “Maintenance of recuperative environment” aimed to offer care that arranged for assistive devices and equipment in the patient's room. “Support of daily life” aimed to offer care that eased accomplishment of daily activities. “Care that respects individuality” aimed to offer care that assessed sources of pleasure for the patient. “Events and complementary and alternative therapies” aimed to offer such care as aromatherapy and massage.
The elements of care identified in this study are useful for all end-of-life cancer patients, even those who do not enter palliative care units. The next step of research is to test the efficacy of interventions that reflect the five identified categories of care for end-of life cancer patients.
缓和医疗的最重要目标之一是实现善终。大多数日本人认为,在生命末期“享受日常生活中的一些乐趣”是必要的。本研究旨在从医生和护士的角度确定一种护理策略,以确保癌症患者在生命末期享受日常生活的乐趣。
我们对姑息治疗病房的专家进行了半结构式访谈。共有 45 名参与者,包括 22 名姑息治疗医生和 23 名护士。使用内容分析法对访谈记录进行分析。
确保终末期癌症患者享受日常生活乐趣的护理可分为五类:“疼痛评估和疼痛缓解”旨在提供身体和心理疼痛评估和缓解。“康复环境维护”旨在提供在患者房间中安排辅助设备和设备的护理。“日常生活支持”旨在提供便于完成日常活动的护理。“尊重个性的护理”旨在提供评估患者乐趣来源的护理。“活动和补充替代疗法”旨在提供如芳香疗法和按摩等护理。
本研究确定的护理要素对所有终末期癌症患者都有用,即使他们不进入姑息治疗病房。下一步的研究是测试反映这五个确定的护理类别的干预措施对终末期癌症患者的疗效。