The clinical and social dimensions of prescribing palliative home oxygen for refractory dyspnea.
The clinical and social dimensions of prescribing palliative home oxygen for refractory dyspnea.
复制标题
为顽固性呼吸困难处方姑息性家庭氧气的临床和社会维度。
DOI：
10.1089/jpm.2012.0102
复制
发表时间：
2013
影响因子：
2.8
通讯作者：
D. Currow
中科院分区：
文献类型：
--
作者：
K. Breaden;J. Phillips;M. Agar;C. Grbich;A. Abernethy;D. Currow
背景
慢性呼吸困难是姑息治疗中的一个重要问题，氧气通常被用来改善它。通常，这种处方福尔斯不符合目前长期家庭氧气使用的资助指南。本质性研究的目的是了解最影响澳大利亚专科姑息护理护士开始为他们的病人家庭氧气的因素。
方法
2011年，在澳大利亚三个州举行了一系列焦点小组会议，与会者包括专门的姑息治疗护士。通过护士全国协会的电子邮件向护士发出了邀请。记录和转录的数据按主题和次主题进行编码。向与会者提供了一份摘要，其中包括报价，以供确认。
结果
五十一名经验丰富的姑息治疗护士参加了在三个首都城市举行的七个焦点小组。确定了两个主要主题：1）涉及当地处方背景的后勤/卫生服务问题（本文中未报告为特定于澳大利亚背景），2）涉及评估患者对家庭氧气的需求和持续监测问题的临床护理问题。参与启动或处方氧气的姑息治疗护士经常报告在其他干预措施试验后使用氧气作为二线治疗，这些干预措施没有提供足够的症状获益。安全问题是一个普遍关注的问题，一个人独自生活并没有成为一个具体的问题，在接受采访的护士。
结论
氧气的作用目前被视为第二线治疗难治性呼吸困难的专科姑息治疗护士。
BACKGROUND
Chronic breathlessness is a significant problem in palliative care and oxygen is often prescribed in an attempt to ameliorate it. Often, this prescription falls outside the current funding guidelines for long-term home oxygen use. The aim of this qualitative study was to understand the factors that most influence Australian specialist palliative care nurses' initiation of home oxygen for their patients.
METHODS
A series of focus groups were held across three states in Australia in 2011 involving specialist palliative care nurses. The invitation to the nurses was sent by e-mail through their national association. Recorded and transcribed data were coded for themes and subthemes. A summary, which included quotes, was provided to participants to confirm.
RESULTS
Fifty-one experienced palliative care nurses participated in seven focus groups held in three capital cities. Two major themes were identified: 1) logistic/health service issues (not reported in this paper as specific to the Australian context) involving the local context of prescribing and, 2) clinical care issues that involved assessing the patient's need for home oxygen and ongoing monitoring concerns. Palliative care nurses involved in initiating or prescribing oxygen often reported using oxygen as a second-line treatment after other interventions had been trialed and these had not provided sufficient symptomatic benefit. Safety issues were a universal concern and a person living alone did not emerge as a specific issue among the nurses interviewed.
CONCLUSION
The role of oxygen is currently seen as a second-line therapy in refractory dyspnea by specialist palliative care nurses.