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Chronological Needs in Terminal Care Management of Frail Elderly Person

体弱老人临终护理管理的时间需求

基本信息

批准号：
15530386
负责人：
SHINODA Michiko
金额：
$ 1.86万
依托单位：
Nihon Fukushi University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

Care management for meeting the temporal needs of terminal-stage elderly individuals requiring nursing care1.Analysis of temporal changes was performed for terminal-stage elderly individuals requiring nursing care for conditions other than cancer (e.g.chronic respiratory failure, stroke, severe dementia).1)Among the elderly individuals requiring nursing care, a common symptom that decreased gradually was oral intake.2)Opinions regarding the appropriateness of intravenous treatment varied among doctors, nurses, and families.3)Although senility was sometimes suspected, some individuals were found to be dehydrated or have mild pneumonia instead, and recovered with treatment.4)Symptoms such as edema, dehydration, pain, breathing difficulty, fever, and bedsores were common, and require palliative knowledge and skills.2.Four conditions for high-quality care managementResults of a survey conducted on nurses at home-visit nursing care facilities revealed the following 4 conditions for high-qua … More lity terminal care : 1)indication of the individual's and his/her family's intent, 2)ability of nurses to maintain care and support from people around the individual, 3)medical care that supports terminal care, and 4)care management that connects the resources available for realizing the desires of the individual and his/her family, In addition, a format that applies these 4 conditions, "Terminal care clinical path", was created, and refined for applications in case investigations.3.Terminal care in FranceData collected from interviews conducted for the home hospitalization federation (HAD, Hospitalization a domicile) and nurse practitioners in Paris, France, are summarized below :1)At-home death rate was 15%, and has leveled off in recent years.2)85% of subject patients at HAD were cancer patients, and a month of intensive care is provided immediately after discharge. Mean stay at facilities is 18.3 days. Care provided includes administration of anticancer drugs, pain management, central intravenous nutrition, nutritional management, infusion, and psychological and social care.3)Conditions necessary for terminal care during home hospitalization comprise smooth cooperation between hospitals and clinics, availability of a full-time coordinator (under a doctor's charge), a multidisciplinary team approach, and high-quality palliative care skills and nursing methods.4)The role of nurse practitioners in terminal care is not to provide advanced medical technology, but to provide nursing care close to nursing. Less

满足需要护理的终末期老年人的时间需求的护理管理1。对因癌症以外的疾病（如慢性呼吸衰竭、中风、严重痴呆）而需要护理的终末期老年人进行了时间变化分析。1)在需要护理的老年人中，口腔摄入是逐渐减少的常见症状。2)医生、护士和家庭对静脉注射是否合适的看法各不相同。3)虽然有时怀疑衰老，但有些人反而发现脱水或轻度肺炎，经治疗后痊愈。水肿、脱水、疼痛、呼吸困难、发热和褥疮等症状是常见的，需要姑息治疗知识和技能。对家访护理机构护士进行的一项调查显示，高质量临终关怀的4个条件：1)个人及其家庭意图的指示；2)护士维持个人周围人的关心和支持的能力；3)支持临终关怀的医疗护理；4)连接实现个人及其家庭愿望的可用资源的护理管理。此外，创建了一个适用于这4个条件的格式，即“临终关怀临床路径”，并对其进行了细化，以用于案例调查。法国的临终关怀从对法国巴黎家庭住院联合会（HAD）和执业护士的访谈中收集的数据总结如下：1)家庭死亡率为15%，近年来趋于稳定。2)85%的HAD受试者为癌症患者，出院后立即给予1个月的重症监护。平均住宿时间为18.3天。提供的护理包括抗癌药的管理、疼痛管理、中心静脉营养、营养管理、输液以及心理和社会护理。3)居家住院期间进行临终护理的必要条件包括医院和诊所之间的顺利合作、是否有全职协调员（由医生负责）、多学科团队方法以及高质量的姑息治疗技能和护理方法。4)执业护士在临终关怀中的作用不是提供先进的医疗技术，而是提供接近护理的护理。少