Phi Gamma, Associate Professor, The Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic.
Head of Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic.
J Nurs Scholarsh. 2018 Mar;50(2):126-133. doi: 10.1111/jnu.12341. Epub 2017 Sep 4.
Comfort promotion plays a significant role in end-of-life patient care. The objective of this study was to determine the utilization rate of comfort supporting nursing activities in end-of-life patients in an institutionalized environment in the Czech Republic in relation to the age of the registered nurses (RNs), length of work experience, education level, and type of workplace.
A cross-sectional, descriptive study was designed. A questionnaire with Likert scales included 31 activities of dying care and spiritual support interventions. The sample comprised 907 RNs working in 49 institutions in nine regions of the Czech Republic. The Kruskal-Wallis test, Mann-Whitney U post-hoc test with Bonferroni correction of significance, Spearman's correlation analysis, and logical regression model were used for statistical evaluation.
The least frequently implemented activity by RNs was "Show the patient's willingness to discuss death" and the most frequent activity was "Threat to the patient's dignity and respect." The highest utilization rate of nursing activities was reported in the physical dimension, while the lowest utilization rate of nursing activities was in the social dimension set. Significant predictors for the high utilization rate of physical dimension set activities were hospice care departments, long-term care facilities (LTCFs), and the age of RNs. Hospice departments were also a predictor of high utilization rate of activities in the psychological, spiritual, and social dimension set activities.
With the exception of hospice departments, RNs used activities encouraging psychological, spiritual, and social comfort for end-of-life patients less frequently than the physical dimension.
RNs in hospitals and LTCFs focus insufficiently on the spiritual and psychosocial comfort of end-of-life patients. This study is of particular significance to educators who prepare the next generation of nurses.
舒适促进在临终患者护理中起着重要作用。本研究的目的是确定在捷克共和国机构化环境中，临终患者接受舒适支持护理活动的利用率与注册护士（RN）的年龄、工作经验年限、教育水平和工作场所类型之间的关系。
本研究为横断面描述性研究。调查问卷采用 Likert 量表，包括 31 项临终关怀和精神支持干预措施。样本包括在捷克共和国 9 个地区的 49 家机构工作的 907 名 RN。采用 Kruskal-Wallis 检验、Mann-Whitney U 检验后 Bonferroni 校正、Spearman 相关分析和逻辑回归模型进行统计学评估。
RN 实施率最低的活动是“向患者展示讨论死亡的意愿”，实施率最高的活动是“威胁到患者的尊严和尊重”。护理活动的利用率最高的维度是身体，而护理活动的利用率最低的维度是社会。护理活动身体维度利用率高的显著预测因素是临终关怀部门、长期护理机构（LTCF）和 RN 的年龄。临终关怀部门也是心理、精神和社会维度活动利用率高的预测因素。
除临终关怀部门外，RN 对临终患者的心理、精神和社会舒适促进活动的使用频率低于身体维度。
医院和 LTCF 的 RN 对临终患者的精神和社会舒适关注不足。这项研究对教育下一代护士的教育工作者具有特别重要的意义。
