Timely Identification of Patients With Cancer and Family Caregivers in Need of End-of-Life Discussions by Home-Visit Nurses in Japan: A Qualitative Descriptive Study.
Timely Identification of Patients With Cancer and Family Caregivers in Need of End-of-Life Discussions by Home-Visit Nurses in Japan: A Qualitative Descriptive Study.
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DOI：
10.1177/23333936221146048
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发表时间：
2023-01
影响因子：
1.7
通讯作者：
Murakami, Yoshie
中科院分区：
文献类型：
--
作者：
Asaumi, Kurumi;Oki, Masataka;Murakami, Yoshie
关键词：
癌症患者临终 (EOL) 讨论是成功 EOL 护理的关键因素；然而，在日本家庭护理环境中确定这些讨论的最佳时机很困难。为了确定癌症患者及其护理人员需要 EOL 讨论的时间，我们探讨了家访护士何时开始 EOL 讨论。我们采访了 23 名家访护士，并使用定性内容分析法对数据进行了分析。从分析中得出三个主题。参与者认为 EOL 讨论的时机对患者不断变化的健康和护理需求（患者总疼痛的增加）、日常护理中家庭护理人员身体或精神状况的变化（家庭护理人员痛苦的增加）以及患者遵循的 EOL 过程（疾病轨迹）敏感。有必要开发一种工具或在职教育计划，使缺乏经验或新毕业的家访护士能够在适当的时间实施 EOL 讨论。
End-of-life (EOL) discussions for patients with cancer are a key factor of successful EOL care; however, identifying the optimal timing for these discussions in Japanese home-care settings is difficult. To identify the time at which patients with cancer and their caregivers need EOL discussions, we explored when home-visit nurses start EOL discussions. We interviewed 23 home-visit nurses and analyzed the data using qualitative content analysis. Three themes were derived from the analysis. Participants identified the timing of EOL discussions as being sensitive to patients’ changing health and care needs (increases in patient’s total pain), changes in the family caregiver’s physical or mental condition through daily care (increases in family caregiver distress), and the EOL process that patients follow (trajectory of disease). Developing a tool or in-service educational program that will enable inexperienced or new graduate home-visit nurses to implement EOL discussions at appropriate times is necessary.
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影响因子：
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