What Knowledge and Skills Do Caregivers Need?
What Knowledge and Skills Do Caregivers Need?
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DOI：
10.1097/01.naj.0000336408.52872.d2
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发表时间：
2008-09-01
影响因子：
2.7
通讯作者：
Given, Charles W.
中科院分区：
文献类型：
--
作者：
Given, Barbara;Sherwood, Paula R.;Given, Charles W.
提供护理的需求取决于各种因素，如病人的个性;疾病的类型或阶段;和照顾者的身体，认知，社会，组织和心理知识和技能。专业人员必须评估护理需求，同时评估护理人员的可用性，能力，知识，技能，竞争的家庭角色和资源。在与家人一起实施治疗护理计划时，必须考虑护理的可预测性和常规性质及其持续时间（数周或数月）和数量（每日护理小时数）。17，18护理人员需要执行复杂的医疗任务，监督患者，做出决定，解决问题，提供情感支持和安慰，并协调护理。使用这些技能，护理人员管理药物，计划和提供膳食，处理医疗设备，并提供直接护理，如伤口护理和提升和转动。护理人员还提供监护、运输和宣传。有些任务仅仅是耗时的;其他任务则很困难。家庭照顾者通常也管理家务。为了改善患者的功能和安全性，护理人员可能需要改变环境并获取设备和辅助设备。护理人员还需要学会监测患者的新体征和症状，不良事件以及对治疗的积极反应。如果病人有认知障碍或神经心理学症状，护理就更加复杂，家庭的痛苦也更加严重。6，19症状严重程度的变化或随着疾病进展出现的新症状可能会提高护理人员对失控的感知。这可能会导致痛苦和不确定性，因为症状恶化或加重会影响身体功能并增加对护理的需求。20，21随着症状的变化，护理人员应直接与卫生保健提供者沟通。随着治疗计划的改变、疾病的进展、患者的功能或认知能力的恶化或患者接近生命的尽头，对护理人员的要求也会升级。护士和社会工作者应该重新评估照顾者的能力时，这种变化发生。
The demands of providing care depend on factors such as the patient’s personality; the type or stage of illness; and the caregivers’ physical, cognitive, social, organizational, and psychological knowledge and skills. Professionals must assess care demands while evaluating the caregiver’s availability, capacity, knowledge, skills, competing family roles, and resources. The predictability and routine nature of the care as well as its duration (weeks or months) and quantity (daily hours of care) must be considered when implementing therapeutic plans of care with the family. 17, 18 Caregivers need to perform complex medical tasks, supervise patients, make decisions, solve problems, provide emotional support and comfort, and coordinate care. Using these skills, caregivers administer medications, plan and provide meals, handle medical equipment, and provide direct care such as wound care and lifting and turning. Caregivers also provide custodial care, transportation, and advocacy. Some tasks are merely time-consuming; others are difficult. Family caregivers also typically manage the household. To improve function and safety for the patient, caregivers may need to modify the environment and acquire equipment and assistive devices. Caregivers also need to learn to monitor patients for new signs and symptoms, adverse events, and positive responses to treatment. Caregiving is more complex and the family’s distress more acute if the patient has impaired cognition or neuropsychological symptoms. 6, 19 Changes in the severity of symptoms or the appearance of new symptoms as the disease progresses can heighten the caregiver’s perception of loss of control. This may cause distress and uncertainty because worsening or increasing symptoms can affect physical function and increase the demand for care. 20, 21 As symptoms change, caregivers should communicate directly with health care providers. Demands on caregivers escalate as treatment plans change, the disease progresses, the patient’s functional or cognitive capacity deteriorates, or the patient nears the end of life. Nurses and social workers should reassess caregivers’ capabilities when such changes occur.