Hospice Providers' Key Approaches to Support Informal Caregivers in Managing Medications for Patients in Private Residences
Hospice Providers' Key Approaches to Support Informal Caregivers in Managing Medications for Patients in Private Residences
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DOI：
10.1016/j.jpainsymman.2011.06.025
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发表时间：
2012-06-01
影响因子：
4.7
通讯作者：
Shega, Joseph W.
中科院分区：
文献类型：
--
作者：
Lau, Denys T.;Joyce, Brian;Shega, Joseph W.
语境。对于在家接受临终关怀的患者的非正式护理人员来说，管理和服用药物来缓解疼痛和症状是常见且重要的责任。然而，人们对临终关怀服务提供者如何准备和支持护理人员完成与药物相关的任务知之甚少。目标。这项定性研究探讨了临终关怀服务提供者用于促进护理人员药物管理的关键方法。方法。对来自美国中西部城市环境中四个临终关怀组织的 22 名提供者（14 名护士、4 名医生和 4 名社会工作者）进行了半结构化、开放式访谈。根据访谈，出现了以下五种关键方法，构成了临终关怀团队如何共同帮助护理人员管理药物：1）建立信任； 2）提供信息； 3）增强自信心； 4) 提供救济（例如，提供家庭药物援助、调动支持资源和简化处方）； 5) 评估理解和表现。每个临终关怀学科都使用多种方法。护士强调为个人护理人员和患者提供定制信息，提供家庭援助以帮助护理人员缓解压力，并在家访期间评估护理人员对药物管理的理解和表现。医生简化药物处方以减轻负担，并利用他们认为的医疗权威让护理人员放心。社会工作者通过提供情感支持以增强自信心并调动护理人员支持网络和整个社区的资源来促进药物管理。结论。临终关怀护士、医生和社会工作者确定了帮助护理人员进行药物管理的不同但重叠的方法。这些发现强调了临终关怀服务提供者之间跨学科团队合作的重要性。未来的研究应该调查这些方法在实践中的普遍性、标准化、有效性和效率。疼痛症状管理杂志，2012； 43：1060-1071。 (C) 2012 年美国癌症疼痛缓解委员会。由爱思唯尔公司出版。保留所有权利。
Context. Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks.Objectives. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers.Methods. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S.Results. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large.Conclusion. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in practice. J Pain Symptom Manage 2012; 43: 1060-1071. (C) 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.