加强加纳的临终关怀：护士满足患者需求的策略与实践。
Enhancing end-of-life care in Ghana: nurse strategies and practices in addressing patient needs.
作者信息
Osei Evans Appiah, Aquah Agnes Abena, Appiah Stella, Nasreen Lalani, Oware Jenifer, Sarpong Collins, Asuboni Zachariah, Omoze Hillary Ongoyo
机构信息
Department of Nursing/Gerontology, Purdue University, 425 South River Road, West Lafayette, Indiana, USA.
Department of Nursing, Valley View University, Accra, Ghana.
出版信息
BMC Palliat Care. 2025 Mar 14;24(1):70. doi: 10.1186/s12904-025-01706-5.
BACKGROUND
Globally, end-of-life care is vital for individuals in their final months or years, emphasizing comfort and dignity. However, the provision of palliative care in low-resource countries, such as Ghana, remains inadequately documented and poorly understood. This study aimed to identify the specific end-of-life care needs of patients and families and explore strategies to enhance end of life care practices among nurses in selected settings in Accra, Ghana.
METHODOLOGY
This qualitative research utilized in-depth, one-on-one interviews using semi-structured interviews in a sample of N = 32 nurses working in two selected hospitals in Ghana. Thematic content analysis was used to analyze the data. Participants were purposively selected, with the sample size determined by data saturation.
RESULTS
The analysis identified three main themes and eleven subthemes. The main themes were: providing dignity and comfort care, respecting ethical values, and perceptions of end-of-life care. The subthemes included: showing presence, demonstrating compassion, addressing challenges in end-of-life conversations, fostering autonomy and respect, managing gratitude and discontent, helping patients accept their condition, seeking additional training, building emotional connections, involving families, and respecting patients' cultural, social, and religious beliefs. The participants had cared for or were currently caring for patients aged 50-75 years with cancer, organ failures, Advanced Heart diseases and cognitive disorders. Participants described their efforts to make the last days of their patients and families memorable as possible.
CONCLUSIONS
Nurses in Ghana provide compassionate care, addressing pain relief, ethical concerns, and patient expressions of gratitude and discontent, with their efforts influenced by religious and cultural factors. To enhance end of life care quality, policymakers should implement structured end-of-life care training for nurses and develop culturally aligned palliative care guidelines to meet the needs of patients receiving end of life care.
背景
在全球范围内，临终关怀对于处于生命最后几个月或几年的个人至关重要，它强调舒适和尊严。然而，在加纳等资源匮乏的国家，姑息治疗的提供情况仍记录不足且了解甚少。本研究旨在确定患者及其家庭在临终关怀方面的具体需求，并探索在加纳阿克拉选定地区提高护士临终关怀实践水平的策略。
方法
本定性研究采用深入的一对一访谈，对加纳两家选定医院工作的N = 32名护士进行半结构化访谈。采用主题内容分析法对数据进行分析。参与者是有目的地选择的，样本量由数据饱和确定。
结果
分析确定了三个主要主题和十一个子主题。主要主题为：提供尊严和舒适护理、尊重伦理价值观以及对临终关怀的认知。子主题包括：陪伴、表达同情、应对临终谈话中的挑战、促进自主性和尊重、处理感激与不满、帮助患者接受病情、寻求额外培训、建立情感联系、让家属参与以及尊重患者的文化、社会和宗教信仰。参与者曾护理或正在护理年龄在50 - 75岁之间患有癌症、器官衰竭、晚期心脏病和认知障碍的患者。参与者描述了他们努力让患者及其家人的最后时光尽可能令人难忘。
结论
加纳的护士提供富有同情心的护理，解决疼痛缓解、伦理问题以及患者的感激和不满表达，他们的努力受到宗教和文化因素的影响。为提高临终关怀质量，政策制定者应为护士实施结构化的临终关怀培训，并制定符合文化背景的姑息治疗指南，以满足接受临终关怀患者的需求。
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