Family perspectives on end-of-life care experiences in nursing homes
Family perspectives on end-of-life care experiences in nursing homes
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DOI：
10.1093/geront/45.5.642
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发表时间：
2005-10-01
期刊：
影响因子：
5.7
通讯作者：
Welch, L
中科院分区：
文献类型：
--
作者：
Wetle, T;Shield, R;Welch, L
目的：本研究的目的是扩大有关临终关怀的知识，收到养老院通过使用的叙述性访谈接近死者的家庭成员。设计和方法：我们对54名受访者进行了后续定性访谈，这些受访者参加了早些时候对1，578名受访者的全国调查。访谈被录音和转录，然后由一个由五名成员组成的多学科小组编码，以确定总体主题。结果：受访者报告说，临终病人的需求往往没有得到充分的医疗保健专业人员。他们对养老院的低期望和他们的经历使许多人成为警惕的倡导者。受访者报告说，医生往往“在行动中失踪”，他们希望更多和更好的培训人员。他们指出，法规加强了以任务为中心，而不是以人为中心的护理，并增加了病人和家庭的负担。虽然临终关怀服务据报道，以加强临终关怀，受访者也报告了延迟转诊和偶尔误解的作用和范围的临终关怀。影响：需要在许多方面持续努力，以改善养老院的临终关怀。提出了政策建议。
Purpose: The purpose of this study is to expand knowledge regarding end-of-life care received in nursing homes through the use of narrative interviews with family members close to the decedents. Design and Methods: We conducted follow-up qualitative interviews with 54 respondents who had participated in an earlier national survey of 1,578 informants. Interviews were taped and transcribed and then coded by a five-member, multidisciplinary team to identify overarching themes. Results: Respondents report that the needs of dying patients are often insufficiently addressed by health care professionals. Their low expectations of nursing homes and their experiences cause many to become vigilant advocates. Respondents report that physicians are often "missing in action," and they desire more and better trained staff. They indicate that regulations reinforce task-focused rather than person-centered care and add to patient and family burden. Although hospice services are reported to enhance end-of-life care, respondents also report late referrals and occasional misunderstandings about the role and scope of hospice. Implications: Sustained efforts on many fronts are needed to improve end-of-life care in nursing homes. Policy recommendations are suggested.