Quality of care of the terminally ill: the carer's perspective
Quality of care of the terminally ill: the carer's perspective
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绝症患者的护理质量：护理者的视角
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
S. Chell
中科院分区：
文献类型：
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作者：
N. Sykes;S. Pearson;S. Chell
庞蒂弗拉克特卫生区 106 名死于癌症的患者的护理人员的经验和意见是在丧亲后大约六个月通过半结构化访谈获得的。通过配额抽样选择在家中或医院死亡的均衡患者群体。访谈调查了关键护理领域的感知质量，并收集了护理人员对服务的自发评论。这些评论被分为以下与医疗保健满意度相关的类别： 护理组织；与医疗保健专业人员的人际关系；信息沟通；还有医院的酒店服务和环境。总共 106 名护理人员（占所接触者的 63%）接受了采访，不同类别患者的回复率没有显着差异。尽管对医疗治疗总体感到满意，但 65% 的护理人员表示症状控制不足；尽管几乎具有普遍资格，但 58% 的患者没有申请任何经济福利。近 60% 的患者在医院死亡，但其中只有 40% 的病例死亡时有护理人员在场。超过一半的护理人员自丧亲之痛后没有得到任何支持。关于姑息治疗和与工作人员的关系的自发评论普遍是有利的，但对与专业人员的沟通和护理组织持高度批评态度，尽管没有护理人员提出任何正式投诉。与地区综合医院相比，更倾向于选择较小的当地医院。结论是，非正式护理人员提供了关于姑息治疗质量的视角，这对卫生专业人员的视角起到了补充作用。收集护理人员观点的方法不应限制对卫生专业人员认为重要的领域的评论，应成为对提供姑息治疗所涉及的所有服务进行监测和评估的一个组成部分。事实证明，这项研究的结果对于将卫生当局的注意力引导到以前未认识到缺陷的服务提供领域具有很大的影响力。
The experience and opinions of carers of 106 patients dying of cancer in Pontefract Health District were obtained by semistructured interview approximately six months after bereavement. A balanced population of patients who had died either at home or in hospital was selected by quota sampling. The interview investigated the perceived quality of key areas of care and also collected carers' spontaneous comments about the service. These comments were grouped into the following categories related to dimensions of satisfaction with health care: organization of care; interpersonal relationships with health care professionals; communication of information; and the hotel services and environment in hospital. A total of 106 carers, 63% of those contacted, were interviewed and there was no significant difference in response rate between patient categories. Despite general satisfaction with medical treatment, 65% of carers cited inadequate control of symptoms; 58% of patients had not applied for any financial benefits, despite almost universal eligibility. Nearly 60% of patients had died in hospital, but a carer was present at the time of death in only 40% of these cases. Over half the carers had received no support since bereavement. Spontaneous comments about palliative care and relationships with staff were generally favourable, but were highly critical of communication with professionals and of the organization of care, although no carer had lodged any formal complaint. A smaller, local hospital was preferred to the district general hospital. It is concluded that informal carers provide a perspective on the quality of palliative care which complements that of health professionals. Methods of gathering carers' views which do not restrict comment to those areas perceived as important by health professionals should be an integral component of the monitoring and evaluation of all services involved in the provision of palliative care. The results of this study have already proved highly influential in directing the attention of the health authority to areas of service provision where deficiencies had not previously been recognized.