老年患者对临终关怀照护需求及其影响因素研究

Study on the demand for hospice care and its influencing factors in elderly patients

目的:调查老年患者对临终关怀的照护需求现状,并分析其需求影响因素。方法:以便利抽样方法抽取杭州市上城区、西湖区、滨江区、下城区和拱墅区5家三甲医院的365名老年患者,采用自行设计的《老年患者对临终关怀照护需求调查问卷》进行调查。结果:(1)老年患者对临终关怀照护需求各维度均分由高到低依次为:信息需求>医护行为需求>心理需求>社会支持需求>生理需求>精神需求>临终关怀场所选择需求。(2)单项条目中需求排在前10位的项目包括,希望生命最后时光在家中度过;希望国家加强对临终关怀服务的补贴和支持;减轻痛苦;疼痛时马上给药;在综合性医院接受照护;希望医护人员技术熟练;维护自身尊严;了解用药情况;生活环境安静舒适;在家属陪伴下度过最后时光。(3)婚姻、居住情况、家庭人均月收入、所患疾病类型及自理能力是老年患者需求的主要影响因素。结论:老年患者对临终关怀照护需求较高,医护人员应针对需求影响因素实施服务,满足老年患者需求,提高其生存质量。

Objective： To investigate the status quo of the demand of hospice care for elderly patients and analyze the influencing factors. Methods： A total of 365 elderly patients in 5 tertiary hospitals in Shangcheng District, Xihu District, Binjiang District, Xiacheng District and Gongshu District in Hangzhou City were selected with convenience sampling and were investigated with a self-designed questionnaire for the needs of hospice care for elderly patients. Results： ① The hospice care needs from high to low of the elderly patients were information need〉need for health care behavior〉psychological need〉social support need〉physical need〉spiritual need〉the need of hospice site selection. ② The top ten items in demand included hoping to spend the last time at home, hoping the state to strengthen the hospice care subsidies and support, relieving pain, being given medicine when feeling pain, receiving care in a general hospital, having skilled medical staff, safeguarding one＇s dignity, understanding the medication, quiet and comfortable living environment, and spending time with family. ③ Marriage, living conditions, family per capita monthly income, the type of disease and self-care ability were the main factors which affected the demand. Conclusion： Elderly patients have higher demand for hospice care, the medical staff should aim at the influence factors of demand to implement the targeted service, meet the needs of the elderly patients and improve their quality of life.