McIlfatrick Sonja, Connolly Michael, Collins Rita, Murphy Tara, Johnston Bridget, Larkin Philip
Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.
All Ireland Institute of Hospice and Palliative Care, Dublin, Ireland.
J Clin Nurs. 2017 Dec;26(23-24):4300-4312. doi: 10.1111/jocn.13757. Epub 2017 Mar 28.
To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions.
Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking.
A mixed methods study using online survey and focus group interviews and thematic analysis to examine data.
Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015.
The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared.
Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care.
Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care.
评估社区护士提供的尊严照护干预措施，该措施旨在解决晚期和生命有限疾病患者的尊严问题。
有证据表明，临终患者担心失去尊严，而姑息治疗的核心重点是帮助人们有尊严地离世。虽然社区护士在提供姑息治疗方面发挥着关键作用，但缺乏针对尊严的具体干预措施。
一项混合方法研究，使用在线调查、焦点小组访谈和主题分析来检查数据。
从爱尔兰的四个试点地区招募了24名社区护士，他们对晚期和生命有限疾病患者实施尊严照护干预措施。在2015年3月至6月期间进行了四次焦点小组访谈和在线调查。
社区护士发现尊严照护干预措施很有用。它帮助护士提供全面的临终护理，并有助于对姑息治疗患者进行全面评估，识别那些可能原本不会被注意到的领域。虽然它是一种有用的沟通工具，但他们指出，它引发了一些他们觉得没有准备好应对的情感敏感对话。
在实践中实施尊严照护干预措施具有挑战性。然而，尊严照护干预措施有助于全面评估，并识别出与患者尊严相关的问题，否则这些问题可能无法被识别出来。需要进一步的支持来克服障碍并实现维护尊严的护理。
确保尊严是姑息治疗和临终护理的关键方面；然而，社区护士可能觉得没有能力应对护理的这一方面。实施尊严照护干预措施有助于识别与患者尊严相关的问题并提供全面护理。社区护士需要更多培训来协助处理与尊严和临终护理相关的困难对话。
