Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals.
Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals.
复制标题
日本长期护理医院的护士临终关怀经验：平衡改善医院临终患者的生活质量和维持生命。
DOI：
10.1016/j.anr.2017.08.004
复制
发表时间：
2017
影响因子：
2.2
通讯作者：
T. Sobue
中科院分区：
文献类型：
--
作者：
R. Odachi;T. Tamaki;Mikiko Ito;T. Okita;Yuri Kitamura;T. Sobue
目的在日本，大约80%的死亡发生在医院，特别是长期护理床位。本研究旨在透过改良扎根理论(M-GTA)探讨长期护理病房中这类临终高龄病人的护理方法。方法通过对日本西部地区2014年在长期护理病房、急性护理病房或临终关怀服务机构工作的19名护士进行半结构式访谈获得数据(以允许这些类型病房之间的持续比较)。我们使用M-GTA分析了转录数据。结果从分析中得出的核心类别是“在患者性格不确定的情况下，平衡提高患者的日常生活质量和生命维持护理。”护士对老年患者的护理需求存在不确定性，存在通过高风险护理提高患者生活质量的伦理问题，以及患者死亡后评价自身护理的评价标准。所有护士都有确保所有病人自然死亡的目标。护士对自身护理的接受和评价受到患者家属在患者去世后对护理的反应的严重影响。有必要进行进一步研究，以制定老年人临终护理的评估标准和教育方案。
PurposeIn Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA).MethodsData were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014. We analyzed the transcribed data using M-GTA.ResultsThe core category that emerged from the analysis was “Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character.” Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care.ConclusionsNurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.
233-2。
DOI：
--
发表时间：
--
期刊：
影响因子：
--
作者：
通讯作者：
--