专业人员对开展居家姑息照护服务内容必要性的认知调查

Medical Workers'Perceptions on What Palliative Home Care Service Content Need to be Provided in the Communities

目的针对晚期癌症患者家庭,探讨开展居家姑息照护服务具体内容的必要性。方法采用自制问卷调查法,对64名社区专业人员和57名三级医院肿瘤科专业人员就开展居家姑息照护服务具体内容必要性进行了调查。两组研究对象平均年龄分别(39.02±10.66)岁(、29.82±5.36)岁;两组在年龄、工作时间、受教育水平均存在差异(P<0.01)。结果社区及医院医护人员均以女性为主;两组均积极支持社区开展姑息照护;在对姑息照护熟悉度方面,医院组以熟悉为主,社区组则以了解为主(χ2=54.55,P<0.01);在对社区卫生熟悉度上,社区组以熟悉为主,医院组以了解为主(χ2=21.31,P<0.01)。两组在除气管切开护理、胸腹腔抽吸积液、协助处理善后事宜外的28项服务内容认为有必要开展的专业人员所占比例都在79%以上,两者在7项项目上差异有统计学意义(P<0.05)。结论社区组与医院组整体上认为有必要开展31项服务内容,但在部分具体内容上意见相左。提示在制定居家姑息照护服务内容相关政策和将其付诸实践时,要综合社区与医院肿瘤专业人员两者的意见。

Objective To explore what palliative home care services need to be provided for advanced cancer patients and their families. Methods Sixty-four primary health care workers and 57 medical workers from oncology ward of tertiary hospitals were investigated by a self-designing survey about what palliative home care services need to be provided for advanced cancer patients and their families in Shanghai. The average ages of responders from communities and hospital were 39.02±10.66 and 29.82±5.36. The differences on ages and work-times and education were significant （ P〈0.01）. Results Responders were predominantly femal. All subjects support actively developing palliative home care service; Subjects from hospitals knew well about palliative care ones from communities knew a little （χ^2= 54.55, P〈0.01）, but acquaintances on community health care were just the reverse（χ^2=21.31, P〈0.01 ; More than 79 percent of subjects thought it was important to develop 28 of all 31 items,but they disagreed on the 7 items from phpsical care field（ P 〈0. 05）. Conclusion In principle, the palliative home care service including 31 items is necessary to be practiced, indicating that the necessity of integration of the opinions from community health care workers and oncologists cancer nurses should be considered.