社区医护人员对待临终关怀、死亡和照顾临终患者的态度及相关性分析
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摘要
目的 :调查社区医护人员对待临终关怀、死亡和照顾临终患者的态度,并分析三者之间的相关性。方法:抽取长治市9所社区卫生服务机构的132名医护人员进行问卷调查,结果采用SPSS 22.0软件进行统计分析。结果 :社区医护人员的死亡态度各维度得分分别为:自然接受(3.84±0.57)分、死亡恐惧(3.13±0.76)分,死亡逃避(3.02±0.71)分、逃离接受(2.68±0.84)分、趋近接受(2.66±0.78)分。临终关怀态度和照顾临终患者态度总均分分别为(3.47±0.44)分和(3.43±0.33)分。死亡态度与照顾临终患者态度间:自然接受与以患者及其家属为中心的照顾意识中度相关(r=0.562,P<0.01)。临终关怀态度与照顾临终患者态度间:临终关怀有效性、临终关怀态度总分与照顾临终患者情感、以患者及其家属为中心的照顾意识分别呈中度相关(r=0.509～0.604,P<0.01)。结论:社区医护人员对待死亡、临终关怀和照顾临终患者的态度均较积极。临终关怀态度和照顾临终患者态度之间有较强的相关性。
Objective: To investigate community health care providers' attitude towards end-of-life care, death and caring for dying patients, and analyze the correlation among them. Methods: Totally 132 community health care providers of nine community health institutions in Changzhi city were investigated. Data was analyzed by SPSS 22.0 software. Results:The average scores of attitude towards dimensions of death were: neutral accptance(3.84±0.57), fear of death(3.13±0.76),death avoidance(3.02±0.71), escape acceptance(2.68±0.84), approach acceptance(2.66±0.78). The average scores of attitude towards end-of-life care, caring for dying patients were(3.47±0.44), and(3.43±0.33) respectively. Natural acceptance was moderately correlated with the sense of care centered on patients and their families(r=0.562, P<0.01). There was a moderate correlation between the effectiveness of end-of-life care and the feelings of caring for dying patients(r=0.509, P<0.01), and the sense of care centered on patients and their families(r=0.604, P<0.01), the total score of attitude towards end-of-life care and the feelings of caring for dying patients(r=0.595, P<0.01), and the sense of care centered on patients and their families(r=0.576,P<0.01). Conclusion: Community health care providers' attitude towards death, end-of-life care and caring for dying patients are positive. There is a strong correlation between attitude towards end-of-life care and attitude towards caring for dying patients.
Objective: To investigate community health care providers' attitude towards end-of-life care, death and caring for dying patients, and analyze the correlation among them. Methods: Totally 132 community health care providers of nine community health institutions in Changzhi city were investigated. Data was analyzed by SPSS 22.0 software. Results:The average scores of attitude towards dimensions of death were: neutral accptance(3.84±0.57), fear of death(3.13±0.76),death avoidance(3.02±0.71), escape acceptance(2.68±0.84), approach acceptance(2.66±0.78). The average scores of attitude towards end-of-life care, caring for dying patients were(3.47±0.44), and(3.43±0.33) respectively. Natural acceptance was moderately correlated with the sense of care centered on patients and their families(r=0.562, P<0.01). There was a moderate correlation between the effectiveness of end-of-life care and the feelings of caring for dying patients(r=0.509, P<0.01), and the sense of care centered on patients and their families(r=0.604, P<0.01), the total score of attitude towards end-of-life care and the feelings of caring for dying patients(r=0.595, P<0.01), and the sense of care centered on patients and their families(r=0.576,P<0.01). Conclusion: Community health care providers' attitude towards death, end-of-life care and caring for dying patients are positive. There is a strong correlation between attitude towards end-of-life care and attitude towards caring for dying patients.
引文
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[16]Gillan PC,Van d RPJ,Jeong S.End of life care education,past and present:a review of the literature.Nurse Education Today,2014,34(3):331-342.
[17]范中意,蒋海华,孟利敏,等.癌症病情告知喜好:医护人员、医学生、患者三者差异.医学与哲学(B),2017,38(12):84-87.Fan ZY,Jiang HH,Meng LM,et al.Differences between patients’and students’preferences in cancer disclosure and medical staff's clinical practices.Medicine and Philosophy(B),2017,38(12):84-87.
[18]Girgis A,Sansonfisher RW,Mccarthy WH.Communicating with patients:surgeons’perceptions of their skills and need for training.Anz Journal of Surgery,2010,67(11):775-780.
[19]王卫华.医患矛盾报道中媒体的社会责任.医学与哲学(A),2012,33(8):22-24.Wang WH.Media's social responsibility in reporting of doctor-patient conflicts.Medicine and Philosophy(A),2012,33(8):22-24.
[20]徐丹丹,金贤.医护人员对死亡和临终关怀的态度及影响因素分析.中华全科医师杂志,2017,16(11):881-883.Xu DD,Jin X.Attitude toward death and hospice care among medical staff and its influencing factors.Chinese Journal of General Practitioners,2017,16(11):881-883.
[21]Hee KE,Eunjoo L.Effects of a death education program on life satisfaction and attitude toward death in college students.Journal of Korean Academy of Nursing,2009,39(1):1-9.
[22]唐鲁,李玉香,周玲君,等.死亡教育讲座对护士死亡态度影响的研究.中国护理管理,2015,15(4):440-443.Tang L,Li YX,Zhou LJ,et al.The effect of death education curriculum on nurses'death attitudes.Chinese Nursing Management,2015,15(4):440-443.
[23]章志光,寇彧.社会心理学.3版.北京:人民教育出版社,2015:189-202.Zhang ZG,Kou Y.social psychology.3rd ed.Beijing:People's Education Press,2015:189-202.
[2]陆宇晗,国仁秀,刘莉.肿瘤科护士对照顾终末期癌症患者的职责认同与负性感受研究.中国护理管理,2011,11(2):84-86.Lu YH,Guo RX,Liu L.Oncology nurses’identification with their responsibilities and negative experience in caring for dying cancer patients.Chinese Nursing Management,2011,11(2):84-86.
[3]Keck VE,Walther LS,et al.Nurse encounters with dying and nondying patients.Nursing Research,1977,26(6):465-469.
[4]Braun M,Gordon D,Uziely B.Associations between oncology nurses’attitudes toward death and caring for dying patients.Oncology Nursing Forum,2010,37(1):43-49.
[5]Rooda LA,Clements R,Jordan ML.Nurses'attitudes toward death and caring for dying patients.Oncology Nursing Forum,1999,26(10):1683-1687.
[6]Dunn KS,Otten C,Stephens E.Nursing experience and the care of dying patients.Oncology Nursing Forum,2005,32(1):97-104.
[7]孟召霞,李艳琳,支彩霞,等.护士照顾临终患者态度与个人死亡态度的相关性研究.护理学杂志,2014,29(2):51-53.Meng ZX,Li YL,Zhi CX,et al.Correlation between nurses'attitudes to terminal patients and their personal attitudes toward death.Journal of Nursing Science,2014,29(2):51-53.
[8]闫春妹,刘伟静,张艳梅,等.中医护理本科生的死亡态度及临终关怀态度现状及其相关性分析.护理学报,2015(6):69-72.Yan CM,Liu WJ,Zhang YM,et al.The status quo and correlation of death attitude and hospice care attitude of undergraduates majoring in traditional Chinese medicine nursing.Journal of Nursing(China),2015(6):69-72.
[9]Bradley EH,Cicchetti DV,Fried TR,et al.Attitudes about care at the end of life among clinicians:a quick,reliable,and valid assessment instrument.Journal of Palliative Care,2000,16(1):6-14.
[10]邹敏.上海市护士姑息护理知识和态度的现状调查与分析.上海:第二军医大学,2007.Zou M.Investigation and analysis on the knowledge and attitude of palliative care of nurses in Shanghai.Shanghai:Second Military Medical University,2007.
[11]Frommelt K.The effects of death education on nurses'attitudes toward caring for terminally ill persons and their families.American Journal of Hospice and Palliative Medicine,1991,8(5):37-43.
[12]Wong P,Reker G,Gesser G.Death Attitude Profile-Revised:a multidimensional measure of attitude toward death,in book Neimeyer RA,Death Anxiety Handbook.Washington DC:Taylor&Francis,1994:121-148.
[13]朱海玲,史宝欣.中文版死亡态度描绘量表修订版的信效度研究.中国实用护理杂志,2011,27(8):51-53.Zhu HL,Shi BX.Validation of a Chinese version of death attitude profile-revised.Chinese Journal of Practical Nursing,2011,27(8):51-53.
[14]诸海燕,张宇平,王玲欢,等.基层医院护士安宁疗护知识与照护态度的调查分析.中华现代护理杂志,2016,22(34):4894-4897.Zhu HY,Zhang YP,Wang LH,et al.Investigation of palliative care knowledge and attitude of nurses in primary hospitals.Journal of Modern Nursing,2016,22(34):4894-4897.
[15]赵琪珩,初紫晶,白冰,等.对长春市社区医护人员临终关怀的认知现状调查.中华现代护理杂志,2018,25(2):3021-3025.Zhao QH,Chu ZJ,Bai B,et al.Cognition on hospice care of community health care providers in Changchun city.Journal of Modern Nursing,2018,25(2):3021-3025.
[16]Gillan PC,Van d RPJ,Jeong S.End of life care education,past and present:a review of the literature.Nurse Education Today,2014,34(3):331-342.
[17]范中意,蒋海华,孟利敏,等.癌症病情告知喜好:医护人员、医学生、患者三者差异.医学与哲学(B),2017,38(12):84-87.Fan ZY,Jiang HH,Meng LM,et al.Differences between patients’and students’preferences in cancer disclosure and medical staff's clinical practices.Medicine and Philosophy(B),2017,38(12):84-87.
[18]Girgis A,Sansonfisher RW,Mccarthy WH.Communicating with patients:surgeons’perceptions of their skills and need for training.Anz Journal of Surgery,2010,67(11):775-780.
[19]王卫华.医患矛盾报道中媒体的社会责任.医学与哲学(A),2012,33(8):22-24.Wang WH.Media's social responsibility in reporting of doctor-patient conflicts.Medicine and Philosophy(A),2012,33(8):22-24.
[20]徐丹丹,金贤.医护人员对死亡和临终关怀的态度及影响因素分析.中华全科医师杂志,2017,16(11):881-883.Xu DD,Jin X.Attitude toward death and hospice care among medical staff and its influencing factors.Chinese Journal of General Practitioners,2017,16(11):881-883.
[21]Hee KE,Eunjoo L.Effects of a death education program on life satisfaction and attitude toward death in college students.Journal of Korean Academy of Nursing,2009,39(1):1-9.
[22]唐鲁,李玉香,周玲君,等.死亡教育讲座对护士死亡态度影响的研究.中国护理管理,2015,15(4):440-443.Tang L,Li YX,Zhou LJ,et al.The effect of death education curriculum on nurses'death attitudes.Chinese Nursing Management,2015,15(4):440-443.
[23]章志光,寇彧.社会心理学.3版.北京:人民教育出版社,2015:189-202.Zhang ZG,Kou Y.social psychology.3rd ed.Beijing:People's Education Press,2015:189-202.