Circumstances and Signs of Approaching Death in Patients With Amyotrophic Lateral Sclerosis Undergoing Noninvasive Ventilation in Home Care Settings
Circumstances and Signs of Approaching Death in Patients With Amyotrophic Lateral Sclerosis Undergoing Noninvasive Ventilation in Home Care Settings
复制标题
DOI：
10.1097/jnn.0000000000000362
复制
发表时间：
2018-06-01
影响因子：
2.3
通讯作者：
Ushikubo, Mitsuko
中科院分区：
文献类型：
--
作者：
Ushikubo, Mitsuko
本研究的目的是阐明使用无创正压通气（NPPV）的肌萎缩侧索硬化症（ALS）临终患者的情况和症状，了解如何为接受NPPV治疗的临终ALS患者提供姑息治疗。参与者是 6 名家访护士，他们是家访护理机构的护士长或副护士长。通过个人半结构化访谈和小组访谈收集数据。结果基于对死亡情况和预测的定性分析，显示了 5 类：了解即将死亡的困难、了解即将死亡的几种体征和症状、做好准备并提供在家中临终关怀的重要性、意外造成的死亡以及由护理人员的能力决定的命运。需要进一步研究来收集有关预测临近死亡的丰富数据，以改善无法从 NPPV 中获得足够益处的 NPPV 依赖性 ALS 患者的临终护理。
The purpose of this study was to elucidate the circumstances and symptoms of patients with amyotrophic lateral sclerosis (ALS) using noninvasive positive pressure ventilation (NPPV) in whom death was approaching, to understand how to provide palliative care to dying patients with ALS receiving NPPV management. The participants were 6 home visiting nurses who were head or subhead nurses of a home visiting nursing agency. Data were collected conducting individual semistructured interviews and then group interviews. The results were based on qualitative analysis of the circumstances of death and prognostication and showed 5 categories: difficulties with knowing about approaching death, several signs and symptoms of knowing about approaching death, importance of feeling prepared and provision of palliative care to die at home, death caused by accident, and fate determined by the caregiver's ability. Further research is needed to collect rich data about predicting approaching death to improve end-of-life care for NPPV-dependent ALS patients who do not receive sufficient benefits from NPPV.