Qiao Shina, Zhang Xiaoming, Xiang Weilan, Yao Linyan, Xian Xuemei
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Patient Prefer Adherence. 2023 Apr 14;17:1019-1024. doi: 10.2147/PPA.S406046. eCollection 2023.
Compared to Western countries, palliative and hospice care services are used less often in Asian countries. While both types have been implemented in mainland China in recent years, their utilization rates have not increased satisfactorily. Moreover, few hospitals in mainland China implement hospice care using the hospice shared care model.
This study investigated a case in which the hospice shared care model was implemented for one patient with advanced colon cancer who had received treatment at a general tertiary hospital in mainland China.
Critical points of care included pain symptom management, nutritional support, application of the SHARE model for disease notification, family meetings to assist medical decision-making, relaxation therapy to relieve depressive symptoms, provisions to address end-of-life wishes, and support for primary caregivers.
The patient's basic pain was controlled (Numeric Rating Scale, NRS2-3), and the score of the Depression Screening Scale (PHQ-9) decreased from 15 to 10 after intervention during hospitalization. In the end, the patient died comfortably and peacefully at home.
The hospice shared care team helped the patient with her physical and psychological pain, met her end-of-life wishes, and provided support for the families.
与西方国家相比,亚洲国家较少使用姑息治疗和临终关怀服务。近年来,中国大陆虽然已实施了这两种服务类型,但其利用率并未令人满意地提高。此外,中国大陆很少有医院采用临终关怀共享照护模式实施临终关怀。
本研究调查了中国大陆一家综合性三级医院对一名晚期结肠癌患者采用临终关怀共享照护模式的案例。
关键护理要点包括疼痛症状管理、营养支持、应用SHARE模式进行病情告知、召开家庭会议以协助医疗决策、采用放松疗法缓解抑郁症状、满足临终愿望以及对主要照顾者的支持。
患者的基础疼痛得到控制(数字评分量表,NRS 2-3),住院期间干预后抑郁筛查量表(PHQ-9)评分从15降至10。最终,患者在家中安详离世。
临终关怀共享照护团队帮助患者缓解了身心疼痛,满足了她的临终愿望,并为家属提供了支持。