基于龙氏量表探讨中国长期卧床患者的照护需求

Exploring the care needs of long-term bedridden patients in China based on the Long’s scale

目的基于龙氏量表探讨不同角色人群对床上人照护需求的研究,为长期卧床患者的服务供给体系和应对机制提供依据。方法根据龙氏量表将失能者划分为床上人、家庭人、社会人。根据临床护理指南结合临床护理实际需求,设计功能障碍者照护需求权重调查问卷,照护条目包含7个一级指标,45个二级指标。采用问卷调查的方式于2022年1—10月在深圳市康复专科联盟7家医院多中心开展护士、医师、治疗师、陪护、患者、家属,共六类不同人群对床上人照护条目的重要性进行调查研究。结果床上人的重要照护需求前三位包括:生活照护(饮食照顾、大小便照护、起居照料);基础护理(管道维护、防压疮照护、生命体征监测);康复照护(康复训练、中医理疗、协助辅具使用);安全管理(并发症防控、防止意外、预防感染);尊重照料(隐私保护、尊重人格、尊重生理需求);精神慰藉(家庭支持、沟通交流、心理疏导)。结论六类不同角色人群对床上人的照护需求结果高度一致,可信度较高,为卧床患者的护理内容提供依据,根据需求有针对性地开展照护服务,节约医疗护理资源。

Objective To explore the care needs for bedridden patients suggested by different populations based on the Long’s scale,so as to provide a basis for the service provision system and coping mechanism for long-term bedridden patients.Methods The disabled people were classified into bedridden persons,homebound persons and social persons according to the Long’s scale.Based on the clinical care guidelines and the actual needs of clinical care,a questionnaire on the weighting of care needs of dysfunctional persons was designed,and the care entries contained 7 primary indicators and 45 secondary indicators.The questionnaire was distributed to nurses,physicians,therapists,attendants,patients and family members(a total of six different populations)in multiple centers in seven hospitals of the Shenzhen Rehabilitation Specialist Alliance for investigation of the importance of care entries for bedridden patients from January to October 2022.Results The top three most important care needs of bedridden persons included:care for activities of daily living(dietary,continence,living),basic care(catheter maintenance,pressure sore prevention,monitoring of vital signs),rehabilitation care(rehabilitation training,physiotherapy with traditional Chinese medicine,assistance with the use of assistive devices),safety management(complication prevention and control,accident prevention,infection prevention),respectful care(privacy protection,respect for personality,respect for physical needs),and spiritual consolation(family support,communication,psychological counseling).Conclusion The care needs for bedridden patients suggested by the six different populations are highly consistent and credible,which provides a basis for the content of care to be provided for bedridden patients,and saves medical care resources by providing targeted care services according to needs.