School of Nursing, Faculty of Medical and Health Sciences University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand.
BMC Palliat Care. 2019 Nov 19;18(1):103. doi: 10.1186/s12904-019-0488-4.
Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore palliative care nurse specialists' experiences regarding the benefits of and barriers to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities.
Reflective logs (465), recorded over the course of the yearlong SHARE intervention by the three palliative care nurse specialists from two local hospices, who were the on-site mentors, were qualitatively analyzed by two researchers utilizing inductive content analysis.
Categories emerging from the logs include the importance of relationships, knowledge exchange, communication, and the challenges of providing palliative care in a long-term care setting.
Evidence from the logs indicated that sustained relationships between the palliative care nurse specialists and staff (registered nurses, healthcare assistants) as well as reciprocal learning were key factors supporting the implementation of this palliative care educational intervention. Challenges remain however in relation to staffing levels, which further emphasizes the importance of palliative care nurse specialist presence as a point of stability.
长期护理机构中的老年人在生命末期接受的护理往往无法充分满足他们的需求的风险更高,但长期护理机构的工作人员通常对此准备不足,无法提供姑息治疗。本研究的目的是探讨姑息治疗护士专家在实施姑息治疗教育干预(支持性临终关怀老年人居住交流项目,SHARE)方面的经验,该干预在 20 家长期护理机构中进行。
两位来自两家当地临终关怀机构的姑息治疗护士专家作为现场导师,在为期一年的 SHARE 干预过程中记录了 465 份反思日志,由两位研究人员利用归纳内容分析进行了定性分析。
日志中出现的类别包括人际关系、知识交流、沟通以及在长期护理环境中提供姑息治疗的挑战的重要性。
日志中的证据表明,姑息治疗护士专家与工作人员(注册护士、医疗助理)之间持续的关系以及相互学习是支持实施这种姑息治疗教育干预的关键因素。然而,在人员配置水平方面仍然存在挑战,这进一步强调了姑息治疗护士专家存在的重要性,因为他们是稳定的一点。