原始研究：了解养老院员工对死亡和临终的态度：一项调查。
Original Research: Understanding Nursing Home Staff Attitudes Toward Death and Dying: A Survey.
机构信息
Nhat Bui is an adult gerontology NP at the Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (UCSF). Elizabeth Halifax is an assistant clinical professor in the UCSF School of Nursing. Daniel David is an assistant professor at the New York University Rory Meyers College of Nursing in New York City. Lauren Hunt is an assistant professor in the UCSF School of Nursing and at San Francisco Veterans Affairs Medical Center. Edyssa Uy is an NP at the City of Hope Comprehensive Cancer Center in Duarte, CA. Christine Ritchie is the Kenneth L. Minaker Chair in Geriatrics and director of research for the Division of Palliative Care and Geriatric Medicine at Massachusetts General Hospital in Boston. Caroline Stephens is an associate professor and the Helen Lowe Bamberger Colby Presidential Endowed Chair in Gerontological Nursing at the University of Utah College of Nursing in Salt Lake City. Support for this study included grants from the National Institute on Aging Paul B. Beeson Emerging Leaders Career Development Award (K76AG054862), the UCSF Pepper Center, and the National Institutes of Health (8 KL2 TR000143-08). Contact author: Nhat Bui,
出版信息
Am J Nurs. 2020 Aug;120(8):24-31. doi: 10.1097/01.NAJ.0000694336.19444.5a.
BACKGROUND
Nearly 70% of nursing home residents are eligible for palliative care, yet few receive formal palliative care outside of hospice. Little is known about nursing home staff attitudes, knowledge, skills, and behaviors related to palliative care.
METHODS
We administered a modified survey measuring attitudes toward death to 146 nursing home staff members, including both clinical and nonclinical staff, from 14 nursing homes.
RESULTS
Nursing home staff generally reported feeling comfortable caring for the dying, but half believed the end of life is a time of great suffering. Pain control (63%), loneliness (52%), and depression (48%) were the most important issues identified with regard to these patients, and there was ambivalence about the use of strong pain medications and the utility of feeding tubes at the end of life. Top priorities identified for improving palliative care included greater family involvement (43%), education and training in pain control (50%) and in management of other symptoms (37%), and use of a palliative care team (35%) at their facility.
CONCLUSIONS
Findings show there is a need for more palliative care training and education, which should be built on current staff knowledge, skills, and attitudes toward palliative care.
背景
近 70%的养老院居民有资格接受姑息治疗，但很少有患者在临终关怀之外接受正式的姑息治疗。关于养老院工作人员与姑息治疗相关的态度、知识、技能和行为知之甚少。
方法
我们对来自 14 家养老院的 146 名临床和非临床工作人员进行了一项经改良的、测量对死亡态度的调查。
结果
养老院工作人员普遍表示在照顾临终患者时感到舒适，但有一半人认为生命的尽头是一个非常痛苦的时期。控制疼痛（63%）、孤独（52%）和抑郁（48%）是他们认为这些患者最重要的问题，对于在生命末期使用强力止痛药和喂养管存在矛盾心理。改善姑息治疗的首要任务包括让更多的家属参与进来（43%）、加强疼痛控制方面的教育和培训（50%）以及管理其他症状（37%），并在养老院中使用姑息治疗团队（35%）。
结论
研究结果表明，姑息治疗培训和教育的需求很大，应建立在工作人员现有的姑息治疗知识、技能和态度基础上。
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