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为生命末期的智力障碍者提供以人为本的支持:澳大利亚一项关于未满足需求和策略的定性研究。

Creating person-centred support for people with intellectual disabilities at the end of life: An Australian qualitative study of unmet needs and strategies.

机构信息

161909Curtin University, Australia.

出版信息

J Intellect Disabil. 2020 Dec;24(4):543-558. doi: 10.1177/1744629518823887. Epub 2019 Feb 6.

Abstract

BACKGROUND

People with intellectual disabilities at the end of life are at risk of receiving inadequate and inequitable end-of-life care. This study explores their unmet needs, opportunities for person-centred care and experiences of health service use.

METHODS

Qualitative interviews with 26 experienced health professionals and carers were used to explore their patients' and residents' unmet needs and end-of-life care options and to outline strategies to support them.

RESULTS

A range of challenges and unmet needs experienced by people with intellectual disabilities are presented in themes: (1) accommodation setting at the end of life: dying 'at home'; (2) personal factors and networks: a circle of support; (3) end-of-life medical care and decision-making. Strategies to facilitate good end-of-life care and a model of care are presented.

CONCLUSIONS

Well-prepared and collaborative disability and health service workforces are needed, together with flexible and adequate end-of-life funding to ensure compassionate and person-centred care.

摘要

背景

生命末期的智障人士有接受不足和不平等的临终关怀的风险。本研究探讨了他们未满足的需求、以患者为中心的护理机会以及对卫生服务的使用体验。

方法

采用定性访谈的方法,对 26 名经验丰富的卫生专业人员和护理人员进行了访谈,以探讨他们的患者和居民的未满足的需求和临终关怀选择,并概述了支持他们的策略。

结果

呈现了智障人士在临终关怀方面存在的一系列挑战和未满足的需求,包括:(1)临终时的住宿环境:“在家中”去世;(2)个人因素和社交网络:支持圈;(3)临终医疗护理和决策。还提出了促进良好临终关怀的策略和护理模式。

结论

需要有准备充分、协作的残疾和卫生服务人员,以及灵活和充足的临终关怀资金,以确保富有同情心和以患者为中心的护理。

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