Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
Hospice Kuria, Amsterdam, Netherlands.
BMC Palliat Care. 2020 May 13;19(1):68. doi: 10.1186/s12904-020-00574-5.
Patients in the last phase of their lives often use many medications. Physicians tend to lack awareness that reviewing the usefulness of medication at the end of patients' lives is important. The aim of this study is to gain insight into the perspectives of patients, informal caregivers, nurses and physicians on the role of nurses in medication management at the end of life.
Semi-structured interviews were conducted with patients in the last phase of their lives, in hospitals, hospices and at home; and with their informal caregivers, nurses and physicians. Data were qualitatively analyzed using the constant comparative method.
Seventy-six interviews were conducted, with 17 patients, 12 informal caregivers, 15 nurses, 20 (trainee) medical specialists and 12 family physicians. Participants agreed that the role of the nurse in medication management includes: 1) informing, 2) supporting, 3) representing and 4) involving the patient, their informal caregivers and physicians in medication management. Nurses have a particular role in continuity of care and proximity to the patient. They are expected to contribute to a multidimensional assessment and approach, which is important for promoting patients' interest in medication management at the end of life.
We found that nurses can and should play an important role in medication management at the end of life by informing, supporting, representing and involving all relevant parties. Physicians should appreciate nurses' input to optimize medication management in patients at the end of life. Health care professionals should recognize the role the nurses can have in promoting patients' interest in medication management at the end of life. Nurses should be reinforced by education and training to take up this role.
生命末期的患者常常使用多种药物。医生往往没有意识到，审查患者生命末期药物的使用价值很重要。本研究旨在深入了解患者、非专业护理人员、护士和医生对护士在生命末期药物管理中的作用的看法。
对处于生命末期的患者、在医院、临终关怀机构和家中的患者及其非专业护理人员、护士和医生进行半结构式访谈。使用恒定比较法对数据进行定性分析。
共进行了 76 次访谈，涉及 17 名患者、12 名非专业护理人员、15 名护士、20 名（实习）医学专家和 12 名家庭医生。参与者一致认为，护士在药物管理中的作用包括：1）告知，2）支持，3）代表和 4）让患者、他们的非专业护理人员和医生参与药物管理。护士在护理连续性和接近患者方面具有特殊作用。他们应该为多维评估和方法做出贡献，这对于促进患者对生命末期药物管理的兴趣很重要。
我们发现，护士可以而且应该通过告知、支持、代表和让所有相关方参与，在生命末期的药物管理中发挥重要作用。医生应该重视护士的意见，以优化生命末期患者的药物管理。医疗保健专业人员应该认识到护士在促进患者对生命末期药物管理的兴趣方面可以发挥的作用。应该通过教育和培训来加强护士的作用。
