Characteristics of Nursing Care for Terminally Ill Patients in Hospice/Palliative Care Unit

The purpose of this study was to clarify the characteristics of nursing care for patient with terminally ill in the hospice/palliative care units. Semi-structured interviews on “communication, care, spiritual pain care and prediction of worsening of symptoms” were conducted, incorporating items indicated as important principles of palliative care by Lugton et al. Sixteen nurses at five hospice/ palliative care facilities in urban areas of Japan were surveyed in 2013, and results were analyzed qualitatively. Following characteristics by hospice/palliative care nurses (HPN) were categorized as [HPN sharing meaningful time with the patient] and [HPN’s continual attempts to understand the world in which the patient lives] in the communication;as [HPN providing comfortable care so that patients can value their last moments] and [HPN’s efforts to attend to patients so they can die as they hope to] in the care;and as [HPN’s observation in a range that does not interfere with the patient’s comfort] and [HPN senses that something is different from before] in the prediction of worsening of symptoms. Common characteristic was 【HPN’s support for patients approaching a natural death】. In this study, spiritual pain care was included in the communication and care, and could not be extracted alone. It was suggested that an HPN provides communication, care and prediction of worsening of symptoms with excellent judgment and technological competency, while placing importance on offering support for the patient’s natural death.

Study on treatment and nursing of elderly patients with gastric cancer complicated with diabetes

Objective To study and analyze the treatment and nursing of elderly patients with gastric cancer complicated with diabetes.Methods:different data were analyzed and summarized.Conclusion:the elderly patients with gastric cancer and diabetes can cooperate with the control of blood glucose during the surgical treatment,and strengthen the nursing before and after the operation.

Rational-emotive behavioral intervention helped patients with cancer and their caregivers to manage psychological distress and anxiety symptoms

There is a dearth of evidence-based data on how psychological distress and death anxiety symptoms experienced by cancer patients and caregivers are treated in developing regions. This article sheds light on the report of the findings from a 2016 study that revealed a rational-emotive behavioral intervention helped a select group of cancer patients and their family caregivers to manage problematic assumptions, psychological distress, and death anxiety symptoms in Nigeria.Based on my experience as a co-investigator and corresponding author of this previous study, I addressed the challenges of conducting such a study and the implications for future research in this article. This article encourages future researchers to replicate the study and endeavor to overcome the limitations of the previous study. Funders were also encouraged to ensure increased access to funds for conducting similar studies with cancer patients and their family caregivers in developing countries and other parts of the world.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Family resilience of cancer patients:a concept analysis

Objective:The concept of family resilience of cancer patients was discussed through literature review,which provided reference for nursing of cancer patients.Methods:China National Knowledge Infrastructure(CNKI),Wanfang Database,SinoMed,PubMed,Web of Science,and Embase were systematically searched,and the concept analysis method proposed by Walker and Avant was adopted.Results:In this study,we defined the concept of family resilience,identified attributes,and analyzed the antecedents and consequences.The proposed operational definition of family resilience was:After a family member is diagnosed with cancer,the whole family can actively explore its own unique internal and external resources and advantages,strengthen self-regulation,jointly cope with the crisis by establishing close family relationships,providing mutual support to family members,and interacting with the outside world.Conclusions:The definition of family resilience of cancer patients is conducive to the development of measurement tools and the improvement of family outcomes of adult cancer patients by intervening family resilience factors.

Human Care Theory and Influences on the Life Quality Index of Cancer Patients in Household Life

To investigatetheinfluences of the application of human care theory on the life quality and happiness of cancer patients after they receiveda community nursing care which was implemented by the human care theory. The quality life and the happiness index of 93 patients with cancer living in the six communities in Jillin were assessed, the assessment of the life quality was based on a life quality scale (SF-36) and that of the happiness index was based on Memorial University of Newfoundland Scale of Happiness (MUNSH). The community nurses cared for these patients by applying the theory of human care and the life quality and the happiness index of the patients were observed after the care. The results showed that there were significant differences in the score of 5 dimensions in the eight dimensions of the life quality between before the care and after the care (<0.05), and there were significant differences in the average sores of the positive emotion, positive experience, negative emotion, negative experience and level of happiness included in the happiness index between before the care and after the care (<0.05), suggesting that the theory of human care can be used for the care of patients with cancer and the application of the theory can effectively improve the life quality and the happiness index of the patients, strengthen their problem-solving abilities and let them have a positive attitude towards their lives.

A Review of Grief Counselling Practices for Family Members of Oncology Patients in Hospice Care

In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. Because of this, in the clinical treatment of oncology patients, strengthening hospice care for family members, doing a good job of death education, assisting them to face and participate in the clinical treatment of oncology in a positive way, and avoiding excessive grief can simultaneously improve the quality of life of patients and their families.

Nursing Care in Patient with Advanced Cancer: The Experience of the Adult Oncology Unit of Lomé

Background: Cancer patients suffer physical, psychological, spiritual, and social pains, especially in the advanced stage. Nurses spend more time with patients than any other healthcare team member. This study aimed to assess nurses’ behavior and care experiences in patients with advanced cancer and explore patients’ perceptions of nursing care. Methods: A cross-sectional study was conducted with eight nurses and thirty patients with advanced cancer hospitalized in the oncology unit at Sylvanus Olympio Teaching Hospital of Lomé from July to August 2020. Results: The mean age of nurses was 34.3 years ranging from 23 to 48 years. There were five men (62.5%) and three women (37.5%). The mean duration of working in oncology nursing of all was less than two years. Only one nurse has training in palliative care. Stress (100%), sadness (100%), and fear (50%) were the most frequently expressed feeling of nurses. The frequently expressed difficulties were the lack of training in palliative care (87.5%), insufficiency of nursing staff (75%), and helplessness in front of the patient’s distress (75%). Among the thirty patients, were 22 women (72.7%) and 8 men (27.3%). The needs expressed by the patients were psychological support (n = 11;36.7%), pain relief (n = 10;33.3%), and moral support (n = 9;30%). Most of the patients (73.3%) affirmed that nurses did not inform them well about their disease. Three (10%) were very satisfied with the care provided, 23 patients (76.7%) were satisfied and 4 (13.3%) were unsatisfied. Conclusion: This study revealed that nursing care in Togolese patients with cancer faces many difficulties and there is a need for providing specialized oncology nursing.

Acceptance Process Model of Patients’ Life with Terminally Ill in Home Hospice and Development of a Narrative Approach for Nurses

The prime aim of this study was to find a psychological process model of patients with terminally ill in home hospice investigating the contents of a narrative, and the secondary aim was to create a narrative approach program for nurses. Ten patients narrated their thinking or feelings along with some prepared questions in two sessions. Patients’ narrative data were categorized by a qualitative analysis and 34 categories were chosen. They perceived good points in home hospice like “Being able to spend time freely”, “Close relationships with care staffs and strong confidence”, though they perceived trouble points like “Suffering from putting burden on the people around me” or “Worries about economic problems”. They perceived psychological changes through illness like “Having peace of mind and becoming kind” “Desire for a natural death”. Moreover they perceived their life like “Acceptance of one’s life including illness” “My life lived with satisfaction”. They regarded as important things such as “Spending life time usefully” “Feelings of my family members and of those around me”, and as hopes “Hope to leave my living proof” “Living left time to the fullest”. From these categories, we propose an acceptance model of patients’ life and a narrative program for nurses.

尊严疗法临终护理对晚期肺癌患者希望水平的影响

目的探讨尊严疗法临终护理对晚期肺癌患者希望水平的影响。方法回顾性选取2022年10月至2023年4月无锡市第二人民医院收治的116例晚期肺癌患者为研究对象,利用随机数字表法将其分为观察组和对照组,每组58例。观察组中,男37例、女21例,年龄(64.69±5.63)岁,采用尊严疗法临终护理。对照组中,男36例、女22例,年龄(65.78±5.79)岁,采用常规护理。比较两组患者的希望水平、生活质量及心理状态。采用t检验、χ^(2)检验进行统计比较。结果护理前,两组患者希望水平差异无统计学意义(P>0.05);护理后,观察组患者总希望水平为(39.67±1.47)分,生活质量评分为(84.72±5.18)分,对照组分别为(35.17±3.05)分、(67.96±5.22)分,均高于护理前,且观察组均高于对照组(均P<0.05)。与护理前相比,护理后两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均降低,且观察组低于对照组[(43.52±1.36)分比(45.58±1.40)分,(46.83±1.07)分比(47.96±1.10)分,均P<0.05]。观察组护理满意度为91.38%(53/58),高于对照组的68.97%(40/58),差异有统计学意义(P<0.05)。结论尊严疗法临终护理能够有效改善患者的希望水平、生活质量及心理状态,提高护理满意度。

虚拟现实在癌症晚期患者安宁疗护中的应用

目的探讨虚拟现实(VR)技术在晚期癌症患者安宁疗护症状管理中的应用效果。方法选取2022年7月到2024年1月在浙江省某肿瘤专科医院接受治疗的61例复发/转移的晚期癌症住院患者为研究对象,给予1次30 min的VR放松体验。运用埃德蒙顿症状评估系统(ESAS)中文版对患者的躯体及情绪症状在干预前后即时进行多维度评估,以评价有效性。并使用11点数字评价量表(NRS)即时评估患者在干预前后头晕变化,以观察不良反应发生情况。结果61例入组患者经VR放松干预后,ESAS评分明显低于干预前,且差异具有统计学意义(P<0.05)。头晕NRS评分高于干预前,差异具有统计学意义(P<0.05)。干预后9例患者出现轻度头晕或头晕稍微加重现象,发生率为15%。头晕NRS评分波动在1~2分之间,均可自行缓解。结论虚拟现实技术在晚期癌症患者安宁疗护中的应用,可有效改善晚期癌症患者即时的疼痛、疲乏、恶心、厌食,焦虑和抑郁等症状,且安全可靠,VR技术有望成为晚期癌症患者安宁疗护症状管理中的一种辅助治疗技术。

临床护士为终末期患者实施本土化叙事护理的体验

目的:了解临床护士结合中国传统文化为终末期患者实施叙事护理的体验,为本土化叙事护理的临床推广提供参考。方法:采用滚雪球抽样法,选取12名为终末期患者实施过叙事护理的临床护士进行半结构式访谈,采用主题分析法分析资料。结果:为终末期患者实施本土化叙事护理的过程中,临床护士的体验包括临床变革、实践历程、自我获益、困境与挑战4个主题。结论:通过对终末期患者实施本土化叙事护理,既缓解了临终患者的痛苦,也提升了护士的职业价值感,但叙事护理实践也面临着较多的挑战,需要来自管理层及组织层面的支持,以确保本土化叙事护理实践的可持续发展。

1例终末期乳腺癌伴难治性癌性疼痛患者的安宁疗护

本文回顾1例乳腺癌终末期患者的安宁疗护实践,探讨癌症终末期难治性癌痛患者疼痛控制、恶心呕吐、姑息镇静的护理,聚焦癌症终末期患者心理支持及精神抚慰,为今后安宁疗护临床实践提供参考。

晚期癌症患者基于安心卡引导的优逝护理干预

目的探讨晚期癌症患者安宁疗护中基于安心卡引导的优逝护理干预效果。方法按照入院时间将晚期癌症患者分为对照组与干预组各70例。对照组实施常规护理,干预组在对照组基础上实施基于安心卡引导的优逝护理干预。干预后,比较两组感知安宁疗护质量与优逝得分。结果对照组67例、干预组65例完成研究。干预后干预组感知安宁疗护质量总分、优逝总分及各维度得分显著高于对照组(均P<0.05)。结论基于安心卡引导的优逝护理干预能最大程度地满足晚期癌症患者的期望与需求,改善晚期癌症患者感知的安宁疗护质量,提高患者的优逝水平,达到患者优逝的目的。

癌症终末期患者低价值医疗管理研究进展

阐述了癌症终末期患者低价值医疗的内涵、评价指标、影响因素及管理策略。提出低价值医疗服务受系统方、患方、医方等多方利益相关者影响;应注重临床实践指南的制订与更新,制订权威的标准和可操作规程,促进临终救治服务流程的优化,强化患者家属的教育与沟通,完善医疗保险和全流程监管机制,以减少低价值医疗。

临终患者多感官刺激疗法的最佳证据总结

目的总结安宁疗护中临终患者多感官刺激疗法的最佳证据,为临终患者的生命末期护理提供参考。方法按照“6S”证据金字塔模型,系统检索国内外数据库、指南网站及专业协会网站中关于临终患者多感官刺激的文献,检索时限自2003年1月至2023年11月。根据纳入与排除标准筛选文献后,由2名研究者对纳入的文献进行质量评价、证据提取与汇总。结果最终纳入15篇文献,其中指南1篇,临床决策3篇,证据总结2篇,专家共识1篇,系统评价7篇,随机对照试验1篇。从环境管理、感官刺激2个方面总结12条证据。结论总结的临终患者多感官刺激疗法最佳证据,可作为临床医护人员临终护理的指引或参考。

心理危机多维度干预联合患者参与管理对肝癌介入治疗患者效果研究

目的:探究肝癌介入患者接受心理危机多维度干预联合患者参与管理对睡眠改善效果。方法:选取2022年10月至2023年10月福建医科大学附属泉州市第一医院疼痛科收治的肝癌患者86例作为研究对象,按照随机数字表法随机分成对照组和观察组,每组43例。对照组开展常规护理,观察组开展心理危机多维度干预联合患者参与管理模式。评估干预前后患者心理状态、失眠程度、主观睡眠质量变化。结果:观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)干预后较对照组明显降低(P<0.05)。观察组失眠严重程度指数量表(ISI-C)、匹兹堡睡眠质量指数(PSQI)干预后较对照组明显降低(P<0.05)。结论:肝癌介入患者接受心理危机多维度干预联合患者参与管理,有助于改善负面情绪,减轻失眠症状,改善睡眠质量。

医护患三维团队互助式护理模式对食管癌患者整体照护成效探析

目的:分析医护患三维团队互助式护理模式对食管癌患者整体照护成效,为此类特殊群体的优质照护提供循证支撑。方法:选取我院在2022年1月至2023年10月接诊收治的100例食管癌患者作为研究对象,借助数字表随机化分组,各组命名为观察组和对照组,每组各50例。其中,对照组实施常规性护理方案,观察组实施三维团队互助式护理模式。在干预前及干预后第2 w末,两组患者均接受生活质量量表、护理效果评价表以及满意度量表测评。结果:观察组患者干预后的生理功能、心理状态、社会关系等维度的生活质量评分高于对照组,差异有统计学意义(P<0.05)。观察组干预后在病情控制、营养状况、心理支持、家属参与度等方面的护理效果评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者对服务态度、护理技能、沟通交流、环境设施等方面的满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:食管癌患者引入医护患三维团队互助式护理模式,能提高患者的生活质量,且能提高护理效果,并提高患者对护理服务的满意度水平。

晚期癌症患者居家安宁疗护照护问题与需求现况调查及影响因素分析

目的调查晚期癌症患者居家安宁疗护服务照护问题及需求现况,并分析其影响因素。方法采用便利抽样法,选取2022年11月-2023年4月上海市某三甲医院住院确诊晚期癌症并符合安宁疗护服务准入条件的430例患者为研究对象,采用一般资料调查表在患者住院期间收集其基本信息,居家期间对其采用修订后中文版居家安宁疗护问题与需求问卷(problems and needs in palliative care questionnaire short version,PNPC-sv)进行横断面调查,并通过单因素、多元线性回归等方法分析其影响因素。结果共纳入424例患者,居家安宁疗护问题总得分为8.00(4.00,14.00)分,身体症状、居家自我照护与经济问题得分分别为3.00(0.00,6.00)、1.00(0.00,4.00)和0.00(0.00,3.00)分。居家安宁疗护需求总得分为8.00(4.00,13.75)分,身体症状、居家自我照护与经济问题需求得分分别为3.00(0.00,6.00)、1.00(0.00,4.00)和0.00(0.00,2.00)分。多元线性回归分析结果显示:癌症类型、医疗付费方式、健康状况和经济来源是晚期癌症患者居家安宁疗护问题的主要影响因素,癌症类型、健康状况、经济来源与患者居家安宁疗护需求具有相关性(P<0.05)。结论晚期癌症患者面临较多的居家安宁疗护问题与需求,主要集中在症状控制、居家自我照护和经济压力方面;自评健康状况、经济来源和癌症类型为主要影响因素。未来可加大社区安宁疗护人力和医疗资源配置,建立完善的筹资机制和医保制度,为居家安宁疗护服务开展提供资源和制度保障。

预立安宁整合照护计划对晚期癌症患者生命意义及家属生活质量的影响

目的观察预立安宁整合照护计划对晚期癌症患者生命意义及家属生活质量的影响。方法选取2022年1月至2023年1月南昌大学第一附属医院肿瘤科收治的60例晚期癌症患者作为研究对象,按照随机数字表法分为对照组(30例)和试验组(30例),对照组按照常规方式护理,试验组在对照组的基础上实施预立安宁整合照护计划护理,比较两组患者的癌因性疲乏、患者生命意义、家属生活质量、护理满意度。结果干预后,试验组患者疲乏、活力、注意力、精力、日常生活活动及癌因性疲乏总评分均低于对照组,差异有统计学意义(P<0.05)。干预后试验组患者存在生命意义感、寻求生命意义感及生命意义总评分均高于对照组,差异有统计学意义(P<0.05)。干预后试验组患者家属躯体活动、精力水平、睡眠、社会隔离、情绪反应及诺丁汉健康调查问卷(NHP)总评分均低于对照组,差异有统计学意义(P<0.05)。干预后,试验组患者及家属的护理满意度高于对照组,差异有统计学意义(P<0.05)。结论预立安宁整合照护计划可以提高晚期癌症患者生命意义及家属生活质量。