变革型领导原则在晚期心力衰竭项目中姑息治疗的发展与整合中的应用。

Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program.

作者信息

George Susan, Leasure A Renee

机构信息

Susan George, APRN-ACNP, CNS, CHFN, CCRN, CMC, INTEGRIS Advanced Cardiac Care, Oklahoma City. Susan George has been practicing as an advanced practice registered nurse for ten years. Susan has been a heart failure nurse practitioner at INTEGRIS Advanced Cardiac Care Program for approximately eight years. Prior to her career as nurse practitioner, Susan worked at various roles including heart failure clinical nurse specialist, cardiovascular case manager, critical care nurse, and post coronary care nurse. She enjoys working heart failure patients and is passionate about improving outcomes in heart failure patients. A. Renee Leasure, PhD, RN, APRN-CNS, CCRN, is an associate professor in the College of Nursing, University of Oklahoma, Oklahoma City. Dr Leasure also holds an appointment at the Oklahoma City VAMC as a Research Scientist (WOC). She has over thirty-five years experience working with critically and chronically ill adults.

出版信息

Dimens Crit Care Nurs. 2016 Mar-Apr;35(2):59-65. doi: 10.1097/DCC.0000000000000166.

DOI:10.1097/DCC.0000000000000166

PMID:26836596

Abstract

Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

摘要

心力衰竭（HF）是美国的一个主要健康问题，且已达到流行程度。心力衰竭与显著的发病率、死亡率和成本相关。尽管心力衰竭的预后比许多癌症形式更差，但许多患者、家属和临床医生并未意识到这种严峻的预后。随着疾病进展到晚期心力衰竭，患者面临许多挑战，例如由于症状恶化和频繁住院导致生活质量差。心力衰竭管理给医疗保健系统增加了巨大的经济负担。姑息治疗可以融入心力衰竭护理中，以提高生活质量和症状管理，并满足患者及其家属的身体、精神和心理社会需求。姑息治疗可以与心力衰竭的治愈性或延长生命的治疗同时使用，也可以独立使用。变革型领导原则被用于指导一项计划的制定，以加强姑息治疗在传统晚期心力衰竭护理中的整合。