Martin Tammy, Nolen-Vesterlund Martha, McCauley Roberta
J Hosp Palliat Nurs. 2022 Sep 9. doi: 10.1097/NJH.0000000000000906.
Providing appropriate end-of-life care is not only a critical part of palliative care but a basic human right. Nurses are well positioned to perform this role; however, the delivery of end-of-life care is difficult. The purpose of this project was to prepare nurses to meet the challenges associated with end-of-life care and to optimize the opportunity for a peaceful death. The project comprised a mixed-methods design, analyzing a palliative care training program for a quantitative and qualitative impact on practice. Preintervention focus group discussions resulted in 6 primary themes concerning the care of these patients: ethical challenges, cultural/spiritual difficulties, troubling emotional aspects, communication challenges, frustrations, and basic unfamiliarity with end-of-life care. Nurses expressed uncertainties about their role in end-of-life care and how best to manage challenges within their scope of practice. There was a statistically significant increase in testing scores from pretraining to posttraining. Postintervention discussions identified changes within nursing practice expressed through 5 primary themes: enhanced communication, symptom management, improved emotional response, improved understanding of ethical principles, and the trajectory of death. Nurses need to receive education to understand their role within end-of-life care and effectively care for the dying patient when cure is no longer an option.
提供恰当的临终关怀不仅是姑息治疗的关键部分,也是一项基本人权。护士具备履行这一职责的良好条件;然而,提供临终关怀却很困难。本项目的目的是让护士做好准备,迎接与临终关怀相关的挑战,并优化安详离世的机会。该项目采用混合方法设计,分析一项姑息治疗培训计划对实践产生的定量和定性影响。干预前的焦点小组讨论得出了关于这些患者护理的6个主要主题:伦理挑战、文化/精神困境、令人困扰的情感问题、沟通挑战、挫折感以及对临终关怀的基本陌生感。护士们对自己在临终关怀中的角色以及如何在其执业范围内最好地应对挑战表示不确定。从培训前到培训后,测试成绩有统计学意义的显著提高。干预后的讨论确定了护理实践中的变化,这些变化通过5个主要主题体现出来:沟通增强、症状管理、情感反应改善、对伦理原则的理解提高以及死亡轨迹。护士需要接受教育,以了解自己在临终关怀中的角色,并在治愈不再是选择时有效地照顾临终患者。