Development of End-of-life nursing care at hospitals providing advanced medical treatment for geriatric patients

医院临终护理的发展为老年患者提供先进的医疗服务

基本信息

批准号：
15592346
负责人：
MIZUNO Toshiko
金额：
$ 2.24万
依托单位：
Tokyo Women's Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15592346/
关键词：
hospitals providing advanced medical treatment elderly end of life care development of care program 高齢者高度医療専門病院看護師の認識終末期ケアの課題終末期経過苦痛

项目摘要

Significant research exists on the terminal care of cancer patients, but research on the special characteristics of elderly terminal care is lacking. Considering roughly 80% pass away in medical facilities, terminal care programs accounting for the special characteristics of these patients should be developed.Research conducted to provide information for creating care programs investigated the terminal states of elderly patients before death in advanced medical facilities. The results suggest issues that should be addressed in creating care programs.Comparing these results with malignant tumor terminal care research, pain increases for cancer patients 48 hours before death. Due to reduced consciousness, the suffering of elderly is not as strong. Measures to cope with suffering related to hospital check-in, reduced awareness and difficulty with breathing and respiratory treatment in the days before death are important for elderly terminal care. In cases where awareness impairment limits direct expression of pain, there is a tendency to conclude there is no pain. Methods of evaluating and responding to this suffering need to be developed.The second study analyzes the conditions and difficulties that nurses experience in geriatric end-of-life care. Particular attention is paid to the nursing care patient's receive in the last month of life. The ability to coordinate policies and timing for responding to respiratory distress, discharging patients from the hospital and supporting time at home between doctors and nurses is necessary.Based on these results, a care program was developed that focuses on the end of elderly patients' lives, accommodating patient wishes to be discharged from the hospital, control suffering focused on responding to respiratory distress, coping with intense pain, supporting patients with a lowered capacity for self-care and helping families feel less anxious at patient deathbeds.The program will be refined and expanded in the future.

关于癌症患者的终末护理的重要研究，但是缺乏关于老年终末护理的特殊特征的研究。考虑到医疗机构中大约80％的去世，应开发有关这些患者特殊特征的终末护理计划。进行研究旨在为创建护理计划提供信息，以调查先进医疗机构死亡之前老年患者的终末状态。结果表明，在创建护理程序中应该解决的问题。将这些结果与恶性肿瘤终末护理研究相结合，死亡前48小时癌症患者的疼痛增加。由于意识的降低，老年人的苦难并不那么强烈。应对与医院检查有关的痛苦，在死亡前几天的呼吸和呼吸治疗方面的认识和难度相关的措施对老年终末护理很重要。如果意识障碍限制了直接表达疼痛的情况，则倾向于结论没有疼痛。评估和应对这种苦难的方法需要开发。第二项研究分析了护士在老年终止护理中遇到的条件和困难。特别注意护理患者在生命的最后一个月接受的。 The ability to coordinate policies and timing for responding to respiratory distress, discharging patients from the hospital and supporting time at home between doctors and nurses is necessary.Based on these results, a care program was developed that focuses on the end of elderly patients' lives, accommodating patient wishes to be discharged from the hospital, control suffering focused on responding to respiratory distress, coping with intense pain, supporting patients with a lowered capacity for self-care and helping families feel less anxious at patient临终关系将在未来进行完善和扩展。