Lindop Edward, Beach Rosie, Read Sue
Lecturers in nursing at the Department of Nursing and Midwifery, Keele University, Stoke-on-Trent, England, UK.
Int J Palliat Nurs. 1997 Sep 2;3(5):287-292. doi: 10.12968/ijpn.1997.3.5.287.
This paper argues that there has been a paradigm shift in recent times in the service needs for palliative care as a result of the UK's National Health Service internal market structure, the shift to community care and the rising needs of the private sector. Nursing models associated with palliative care are reviewed and represented within the 'Composite Model of Palliative Care' which blends current and traditional models of care, focusing upon a multidisciplinary approach involving professionals, family and friends. The roles of advocate, manager, educator, carer/therapist, researcher and communicator/counsellor are presented as the vehicle to implement the model of care through a learning contract and associated clinical supervision. The paper also argues that there is a need for specialist palliative care courses at least at diploma level, with appropriate professional recognition, designed to make the paradigm shift and to project this into clinical practice through a tripartite learning contract involving specialist tutor, clinical supervisor and student. The rationale and outline of the course are presented along with the argument that this paradigm shift needs to take place if palliative care is to be truly holistic care.
本文认为，由于英国国民医疗服务体系的内部市场结构、向社区护理的转变以及私营部门需求的增加，近年来姑息治疗的服务需求发生了范式转变。与姑息治疗相关的护理模式在“姑息治疗综合模式”中得到了回顾和呈现，该模式融合了当前和传统的护理模式，重点是涉及专业人员、家人和朋友的多学科方法。倡导者、管理者、教育者、护理人员/治疗师、研究者和沟通者/顾问的角色被视为通过学习合同和相关临床监督来实施护理模式的载体。本文还认为，至少需要有文凭水平的专科姑息治疗课程，并给予适当的专业认可，旨在实现这种范式转变，并通过涉及专科导师、临床督导和学生的三方学习合同将其推广到临床实践中。文中阐述了该课程的基本原理和大纲，同时指出，如果姑息治疗要成为真正的整体护理，就需要发生这种范式转变。
