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1
Enabling ICU patients to die at home.
Nurs Stand. 2014 Oct 7;29(5):46-9. doi: 10.7748/ns.29.5.46.e8971.
2
Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: a correlational, cross-sectional study.探讨姑息治疗中家庭照护者的准备状态相关因素及其对照护者结局的影响:一项相关性、横断面研究。
Palliat Med. 2013 Jul;27(7):639-46. doi: 10.1177/0269216313486954. Epub 2013 May 13.
3
End of life in intensive care: is transfer home an alternative?重症监护中的生命末期:是否可以选择转回家中?
Intensive Crit Care Nurs. 2012 Aug;28(4):234-41. doi: 10.1016/j.iccn.2012.01.006. Epub 2012 Mar 7.
4
Challenges in transition from intervention to end of life care in intensive care: a qualitative study.从重症监护的干预到临终关怀的过渡中的挑战:一项定性研究。
Int J Nurs Stud. 2012 May;49(5):519-27. doi: 10.1016/j.ijnurstu.2011.10.019. Epub 2011 Nov 10.
5
The going home initiative: getting critical care patients home with hospice.回家计划:让重症监护患者与临终关怀一起回家。
Crit Care Nurse. 2011 Oct;31(5):46-57. doi: 10.4037/ccn2011415.
6
Negotiated dying: a grounded theory of how nurses shape withdrawal of treatment in hospital critical care units.协商致死:一项关于护士如何在医院重症监护病房塑造治疗撤退的扎根理论。
Int J Nurs Stud. 2011 Dec;48(12):1466-74. doi: 10.1016/j.ijnurstu.2011.06.003. Epub 2011 Jul 19.
7
Withdrawal of mechanical ventilation in the home: a case report and review of the literature.在家中撤下机械通气:病例报告和文献复习。
Palliat Med. 2011 Jun;25(4):378-81. doi: 10.1177/0269216310396113. Epub 2011 Jan 19.
8
An integrated review of the literature on challenges confronting the acute care staff nurse in discharge planning.对急性护理人员在出院计划中面临的挑战的文献进行综合回顾。
J Clin Nurs. 2011 Mar;20(5-6):754-74. doi: 10.1111/j.1365-2702.2010.03257.x. Epub 2010 Oct 19.
9
Withdrawal of intensive care treatment at home--'a good death'.
Anaesth Intensive Care. 2009 May;37(3):484-6. doi: 10.1177/0310057X0903700305.
10
Going home to die from surgical intensive care units.从外科重症监护病房回家等死。
Intensive Care Med. 2009 May;35(5):810-5. doi: 10.1007/s00134-009-1452-1. Epub 2009 Mar 12.

医生和护士对将重症监护病房的患者转至家中死亡的看法及经验:一项定性探索性研究。

Doctors' and nurses' views and experience of transferring patients from critical care home to die: a qualitative exploratory study.

作者信息

Coombs Maureen, Long-Sutehall Tracy, Darlington Anne-Sophie, Richardson Alison

机构信息

Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand Faculty of Health Sciences, University of Southampton, Southampton, UK.

Faculty of Health Sciences, University of Southampton, Southampton, UK

出版信息

Palliat Med. 2015 Apr;29(4):354-62. doi: 10.1177/0269216314560208. Epub 2014 Dec 17.

DOI:10.1177/0269216314560208
PMID:25519147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4370931/
Abstract

BACKGROUND

Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally.

AIM

To examine current experiences of, practices in and views towards transferring patients in critical care settings home to die.

DESIGN

Exploratory two-stage qualitative study

SETTING/PARTICIPANTS: Six focus groups were held with doctors and nurses from four intensive care units across two large hospital sites in England, general practitioners and community nurses from one community service in the south of England and members of a Patient and Public Forum. A further 15 nurses and 6 consultants from critical care units across the United Kingdom participated in follow-on telephone interviews.

FINDINGS

The practice of transferring critically ill patients home to die is a rare event in the United Kingdom, despite the positive view of health care professionals. Challenges to service provision include patient care needs, uncertain time to death and the view that transfer to community services is a complex, highly time-dependent undertaking.

CONCLUSION

There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting.

摘要

背景

临终患者更倾向于在家中离世,因此临终关怀的一个目标是为患者提供关于死亡地点的选择。然而,在重症监护病房内向患者提供这一选择是否可行,以及团队是否愿意考虑这一选择,在国际上受到的探索有限。

目的

研究在重症监护环境中将患者转至家中离世的当前经验、做法和观点。

设计

探索性两阶段定性研究

设置/参与者:在英国两个大型医院院区的四个重症监护病房与医生和护士、英格兰南部一个社区服务机构的全科医生和社区护士以及一个患者及公众论坛的成员举行了六个焦点小组会议。来自英国各地重症监护病房的另外15名护士和6名顾问参与了后续电话访谈。

结果

在英国,将重症患者转至家中离世的做法很少见,尽管医护人员持积极态度。提供服务面临的挑战包括患者护理需求、死亡时间不确定,以及认为转至社区服务是一项复杂且高度依赖时间的工作。

结论

有证据表明,个人和政策驱动因素推动为所有接近生命终点的成年人提供包括首选死亡地点在内的高质量护理。虽然有证据表明这一选择在一些重症监护人群中得到了尊重和落实,但在这种情况下,这是否会成为临终时的常规做法仍存在争议。