Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members' perceptions.
Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members' perceptions.
复制标题
绝症癌症患者及其家人的临终声音护理策略：来自对失去亲人的家人的看法的全国横断面调查的建议。
DOI：
10.1016/j.jpainsymman.2013.07.010
复制
发表时间：
2014
影响因子：
4.7
通讯作者：
Y. Shima
中科院分区：
文献类型：
--
作者：
Y. Shimizu;M. Miyashita;T. Morita;Kazuki Sato;S. Tsuneto;Y. Shima
目睹病人死亡的家属往往会感到痛苦。然而，在这方面，具体的护理措施，旨在减少死亡摇铃相关的家庭困扰的好处尚未evaluated.ObjectivesTo澄清死亡摇铃相关的情绪困扰水平的家庭成员和他们的看法，需要死亡摇铃护理改善，并探讨影响这两个问题的因素。于2007年6月对95个姑息治疗单位的癌症患者家属进行横断面问卷调查。结果共发放问卷663份，共分析了390份（61%）答复。其中，181人（46%）的受访者经历了死亡的摇铃。其中，66%的人报告了高度的痛苦水平，53%的人认为迫切需要改善临终关怀。影响高痛苦水平的因素是家庭成员的性别（女性），对死亡摇铃是一种自然现象的不了解，以及他们对死亡摇铃的恐惧和痛苦的解释。影响对改善护理的强烈需求的感知的因素是家庭成员的性别（男性）、死亡摇铃的严重程度、死亡摇铃相关的患者不适、家庭成员对护理不足的经历（例如，重新定位）和不充分的咨询有关吸痰，和他们的感知不舒服的气味。ConclusionTo减少家庭感知的痛苦，医务人员应减轻患者的症状和痛苦的综合护理策略，尽量减少不舒服的气味，并与家庭成员沟通，以解决令人痛苦的解释和恐惧。
ContextBereaved family members witnessing a patient's death rattle often experience distress. However, the benefits of specific care measures aimed at decreasing death rattle-associated family distress have not yet been evaluated.ObjectivesTo clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues.MethodsA cross-sectional questionnaire survey of bereaved family members of cancer patients was conducted in 95 palliative care units in June 2007.ResultsSix hundred sixty-three questionnaires were mailed out, and 390 (61%) responses were analyzed. Among these, 181 (46%) respondents experienced death rattle. Of these, 66% reported high distress levels and 53% perceived a strong need for improved death rattle care. Factors influencing high distress levels were the gender (female) of family members, unawareness about death rattle being a natural phenomenon, and their fear and distressing interpretations of death rattle. Factors influencing perceptions of a strong need for improved care were the gender (male) of family members, severity of death rattle, death rattle-associated discomfort to patients, family members' experiences of inadequate nursing care (e.g., repositioning) and insufficient consultation about suctioning, and their perception of uncomfortable smells.ConclusionTo decrease family-perceived distress, medical staff should alleviate patient symptoms and suffering with a comprehensive care strategy, try to decrease uncomfortable smells, and communicate with family members to address distressing interpretations and fears.