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从专业人员视角看教育干预前后养老院姑息治疗的提供情况:一项前后对照设计。

Palliative care delivery at nursing homes before and after an educational intervention from professionals' perspective: A pre-post design.

作者信息

Åvik Persson Helene, Ahlström Gerd, Årestedt Kristofer, Behm Lina, Drevenhorn Eva, Sandgren Anna

机构信息

Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.

出版信息

Scand J Caring Sci. 2023 Mar;37(1):229-242. doi: 10.1111/scs.13084. Epub 2022 May 6.

Abstract

BACKGROUND

The principles of palliative care were developed in hospices and specialised palliative care units and have not been sufficiently adapted to and evaluated in nursing homes. Therefore, an educational intervention from an interprofessional education perspective was performed within the project Implementation of Knowledge-Based Palliative Care in Nursing Homes. The aim of this study was to evaluate professionals' experience of palliative care delivery before and after the educational intervention.

METHODS

The educational intervention for nursing home professionals consisted of five 2-h seminars over 6 months at 20 nursing homes. The intervention and control groups consisted of 129 and 160 professionals from 30 nursing homes respectively. The questionnaire 'Your experience of palliative care' was completed 1 month before (baseline) and after (follow-up) the intervention. Descriptive and inferential statistics were calculated.

RESULTS

The positive effects at follow-up concerned the use of a valid scale for grading symptoms, attendance to the needs of next of kin (including bereavement support), documentation of older persons' wishes regarding place to die and conversations about their transition to palliative care and about how they were treated.

CONCLUSIONS

This study demonstrates a promising interprofessional educational model. However, the paucity of improvements brought to light at follow-up indicates a need for research directed towards a revision of this model. Supervision of professionals during palliative care delivery is one suggestion for change.

摘要

背景

姑息治疗原则是在临终关怀机构和专业姑息治疗单位制定的,尚未充分适用于养老院,也未在养老院进行评估。因此,在“养老院基于知识的姑息治疗实施”项目中,从跨专业教育的角度进行了一项教育干预。本研究的目的是评估专业人员在教育干预前后提供姑息治疗的经验。

方法

针对养老院专业人员的教育干预包括在20家养老院在6个月内举办5次每次2小时的研讨会。干预组和对照组分别由来自30家养老院的129名和160名专业人员组成。在干预前1个月(基线)和干预后(随访)完成“你对姑息治疗的经验”问卷。计算描述性和推断性统计数据。

结果

随访时的积极效果涉及使用有效的症状分级量表、关注亲属的需求(包括丧亲支持)、记录老年人关于死亡地点的意愿以及关于他们向姑息治疗过渡及治疗方式的谈话。

结论

本研究展示了一个有前景的跨专业教育模式。然而,随访中发现的改善不足表明需要开展研究以修订该模式。在提供姑息治疗期间对专业人员进行监督是变革的一个建议。

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