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一个小时的教学干预可以改善临终关怀。

A one hour teaching intervention can improve end-of-life care.

机构信息

Western Kentucky University, School of Nursing, 1906 College Heights Blvd. #11036, Bowling Green, KY 42101, United States.

Bellarmine University, 2001 Newburg Rd, Louisville, KY 40205, United States.

出版信息

Nurse Educ Today. 2018 Aug;67:93-99. doi: 10.1016/j.nedt.2018.05.010. Epub 2018 May 19.

Abstract

BACKGROUND

It is not known if standard nursing actions are tailored to patient preferences for comfort measures during End of Life (EOL) care.

OBJECTIVES

Determine the effect of a brief teaching intervention on student care of EOL patients.

DESIGN

Pre-test/post-test intervention design.

SETTINGS

Two large public universities and one smaller private Catholic institution (all in the United States [U.S.]).

PARTICIPANTS

471 nursing students attending class as part of their required nursing curriculum.

METHODS

A previously developed aggressiveness of nursing care scale was modified to determine students' behavioral intentions for the care of the EOL patient before and after a standardized lecture. The lecture was designed to help students recognize that nursing care priorities for the EOL patient may need to be different than for other patients in order to provide the best quality of remaining life.

RESULTS

Nursing students prior to the lecture had aggressiveness of care scores similar to those of experienced staff nurses, and were more likely to provide more aggressive care to younger patients without DNR orders than to older patients with a DNR order. Following the lecture, aggressiveness of nursing care scores decreased significantly for all EOL patients, and students reported similar behavioral intentions for all EOL patients, regardless of patient age or code status. Student age was marginally related to change in behavior following the lecture. Prior experience in caring for a dying patient or relative did not have a significant effect on aggressiveness of care scores before or after the lecture.

CONCLUSIONS

This study demonstrates the effectiveness of a brief teaching intervention to help student nurses take patient preferences and needs into consideration when selecting nursing interventions for the EOL patient.

摘要

背景

尚不清楚标准护理措施是否针对患者在生命末期(EOL)护理中对舒适措施的偏好进行了调整。

目的

确定简短教学干预对学生 EOL 患者护理的影响。

设计

测试前/测试后干预设计。

地点

两所大型公立大学和一所较小的私立天主教机构(均在美国[美国])。

参与者

471 名护理专业学生,他们正在参加他们必修的护理课程。

方法

先前开发的护理干预攻击性量表经过修改,以确定学生在标准化讲座前后对 EOL 患者护理的行为意向。该讲座旨在帮助学生认识到,为 EOL 患者提供护理的优先级可能需要与其他患者不同,以便提供剩余生命的最佳质量。

结果

在讲座之前,护理专业学生的护理攻击性评分与经验丰富的注册护士相似,并且更有可能为没有 DNR 命令的年轻患者提供更积极的护理,而不是为有 DNR 命令的老年患者提供更积极的护理。讲座后,所有 EOL 患者的护理攻击性评分均显著下降,学生对所有 EOL 患者的行为意向相似,无论患者年龄或代码状态如何。学生年龄与讲座后的行为变化略有相关。在讲座前后,照顾临终患者或亲属的先前经验对护理攻击性评分均无显着影响。

结论

本研究表明,简短教学干预可有效帮助护生在为 EOL 患者选择护理干预措施时考虑患者的偏好和需求。

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