Borneman Tami, Sun Virginia, Williams Anna Cathy, Fujinami Rebecca, Del Ferraro Catherine, Burhenn Peggy S, Irish Terry, Zachariah Finly, van Zyl Carin, Buga Sorin
Senior Research Specialist, Nursing Research and Education, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010.
Assistant Professor, Nursing Research and Education, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010.
J Hosp Palliat Nurs. 2015 Aug;17(4):309-318. doi: 10.1097/NJH.0000000000000165.
Consistent with the recommendations of the Institute of Medicine Report on quality cancer care, attention to symptom management and quality of life concerns of patients with lung cancer should be addressed throughout the disease trajectory. As part of a NCI-funded Program Project grant, this paper reports on the patient and family caregiver education component of a nurse-lead, tailored palliative care intervention for patients with early (I-III, n=130) and late (IV, n=142) stage lung cancer. Patients and family caregivers received 4 separate educational sessions organized around the Quality of Life model domains (physical, psychological, social, and spiritual well-being). Each patient and caregiver was presented at a weekly interdisciplinary case conference which also informed the educational sessions. Based on needs and team suggestions, an individualized palliative care plan was created and a tailored educational intervention was designed based on topics chosen by each participant. The most common topics chosen by patients in each domain were fatigue, worry and fear, social support/isolation, and hope. Family caregivers most commonly chose fatigue, worry and fear, communication, and purpose and meaning in life. The mean time spent in each teaching session ranged from 31 to 44 minutes for patients and 25 to 35 minutes for family caregivers. There is a vital need for interdisciplinary palliative care interventions for patients across all stages and across the disease trajectory. Nurses are vital to integrating palliative care into routine care. Providing a tailored educational intervention is an important aspect of palliative care for patients and family caregivers. This paper focuses on the process of the tailored educational intervention.
与医学研究所关于优质癌症护理的报告建议一致，在肺癌患者的整个疾病进程中，都应关注其症状管理及生活质量问题。作为美国国立癌症研究所资助的项目计划拨款的一部分，本文报告了一项由护士主导、针对早期（I - III期，n = 130）和晚期（IV期，n = 142）肺癌患者的定制姑息治疗干预措施中的患者及家庭护理人员教育部分。患者及家庭护理人员参加了围绕生活质量模型领域（身体、心理、社会和精神健康）组织的4次单独教育课程。每次患者和护理人员都在每周的跨学科病例讨论会上进行展示，该讨论会也为教育课程提供信息。根据需求和团队建议，制定了个性化的姑息治疗计划，并基于每位参与者选择的主题设计了定制的教育干预措施。患者在每个领域选择的最常见主题是疲劳、担忧和恐惧、社会支持/孤立以及希望。家庭护理人员最常选择的主题是疲劳、担忧和恐惧、沟通以及生活的目的和意义。患者每次教学课程的平均时长为31至44分钟，家庭护理人员为25至35分钟。对于处于所有阶段及整个疾病进程的患者而言，迫切需要跨学科的姑息治疗干预措施。护士对于将姑息治疗融入常规护理至关重要。为患者及家庭护理人员提供定制的教育干预措施是姑息治疗的一个重要方面。本文重点关注定制教育干预措施的过程。
