护理人员预立医疗照护计划知信行现状及对策分析
|
摘要
目的:调查护理人员的预立医疗照护计划知信行现状及分析相关影响因素及对策。方法:采用便利抽样方法,使用电子问卷的形式调查来自全国的1036名护理人员。结果:护理人员的预立医疗照护计划知识得分为(6.16±2.34)分,92.7%的护理人员对预立医疗照护计划的开展持支持态度,预立医疗照护计划各条目的参与率均在30.0%以下;影响护理人员预立医疗照护计划知识了解程度的因素是学历、半年内照顾临终患者例数、处理死亡经验;影响护理人员预立医疗照护计划行为的是半年内照顾临终患者的例数、态度、年龄、知识、学历。结论:我国护理人员对预立医疗照护计划的支持率很高,但预立医疗照护计划知识匮乏,参与率也较低;应采取培训等措施,使护理人员为ACP在我国的推行做好充足准备。
Objective: To investigate the knowledge, attitude and practice of Advance Care Planning(ACP) among nurses and explore the influencing factors. Methods: E-questionnaires were delivered to 1036 nurses from all over the country by conventional sampling. Results: The score of knowledge of ACP among nurses was 6.16±2.34. And 97.2% of nurses were in favor of ACP, but the participation rate of each item of ACP was below 30.0%. The influencing factors of ACP knowledge among nurses were education, the number of terminal patients caring for within 6 months, and the experience dealing with deaths. And influencing factors of ACP practices were the number of terminal patients caring for within 6 months, attitude, age, knowledge, and education. Conclusion: The approval rating for ACP among nurses in China is very high, but the knowledge and participation rate are low. Interventions such as relevant training are needed to prepare the nursing staffs for the implementation of ACP in China.
Objective: To investigate the knowledge, attitude and practice of Advance Care Planning(ACP) among nurses and explore the influencing factors. Methods: E-questionnaires were delivered to 1036 nurses from all over the country by conventional sampling. Results: The score of knowledge of ACP among nurses was 6.16±2.34. And 97.2% of nurses were in favor of ACP, but the participation rate of each item of ACP was below 30.0%. The influencing factors of ACP knowledge among nurses were education, the number of terminal patients caring for within 6 months, and the experience dealing with deaths. And influencing factors of ACP practices were the number of terminal patients caring for within 6 months, attitude, age, knowledge, and education. Conclusion: The approval rating for ACP among nurses in China is very high, but the knowledge and participation rate are low. Interventions such as relevant training are needed to prepare the nursing staffs for the implementation of ACP in China.
引文
[1]Detering KM,Hancock AD,Reade MC,et al.The impact of advance care planning on end of life care in elderly patients:randomised controlled trial.British Medical Journal,2010,340(7751):847.
[2]Zwakman M,Jabbarian LJ,van Delden J,et al.Advance care planning:a systematic review about experiences of patients with a life-threatening or life-limiting illness.Palliative Medicine,2018(32):1305-1321.
[3]邓仁丽,陈柳柳,史宝欣,等.中国文化背景下预立医疗照护计划的研究进展.中华护理杂志,2015,50(9):1117-1121.Deng RL,Chen LL,Shi BX,et al.Research progress of advanced care planning under Chinese culture.Chin J Nurs,2015,50(9):1117-1121.
[4]国家卫生计生委办公厅.国家卫生计生委办公厅关于印发安宁疗护实践指南(试行)的通知.(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml.National Health Commission of the People's Republic of China.Notice on the issuance of guidelines for the practice of palliative care(pilot).(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml.
[5]国家卫生计生委.国家卫生计生委关于印发安宁疗护中心基本标准和管理规范(试行)的通知.(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/2f50fdc62fa84cdd9d9a09d5162a661f.shtml.National Health Commission of the People's Republic of China,Notice on the issuance of basic standards and management norms for hospice care centers(pilot).(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/2f50fdc62fa84cdd9d9a09d5162a661f.shtml.
[6]关于促进护理服务业改革与发展的指导意见.中国护理管理,2018,18(7):865-867.Guidance on promoti ng the refor m and development of nursing service.Chinese Nursing Management,2018,18(7):865-867.
[7]Lewis K.How nurses can help ease patient transitions to end of life care.Nurs Older People,2013,25(8):22-26.
[8]Hy C,Sm P.Let me talk-an advance care planning programme for frail nursing home residents.Journal of Clinical Nursing,2010,19(21/22):3073-3084.
[9]张汛滔,郭燕,徐晓霞.医护人员对预先指示的态度及其影响因素分析.中国护理管理,2014,14(8):818-822.Zhang XT,Guo Y,Xu XX.Physician and nurses'attitude towards Advance Directives and its influencing factors.Chinese Nursing Management,2014,14(8):818-822.
[10]李宇芳,邹剑莹,骆坚,等.医护患对实施预立医疗照护计划的态度及影响因素调查.护理学报,2014,21(16):21-24.Li YF,Zou JY,Luo J,et al.Attitude of medical staff and patients toward Advance Directives and its influence factors.Journal of Nursing(China),2014,21(16):21-24.
[11]Siu MW,Cheung TY,Chiu MM,et al.The preparedness of Hong Kong medical students towards advance directives and end-of-life issues.East Asian archives of psychiatry:Official Journal of the Hong Kong College of Psychiatrists,2010,20(4):155.
[12]孙振球.医学统计学.3版.北京:人民卫生出版社,2010.Sun ZQ.Medical statistics.3th ed.Beijing:People's Medical Publishing House,2010.
[13]Aguilar-S?nchez JM,Caba?Ero-Mart?Nez MJ,Puerta FNF,et al.Knowledge and attitudes of health professionals towards advance directives.Gaceta Sanitaria,2018,32(4):339-345.
[14]Shepherd J,Waller A,Sanson-Fisher R,et al.Knowledge of,and participation in,advance care planning:a cross-sectional study of acute and critical care nurses perceptions.International Journal of Nursing Studies,2018,86(6):74-81.
[15]Deng RL,Duan JZ,Zhang JH,et al.Advance care planning for frail older people in China:a discussion paper.Nursing Ethics,2018:969733018779177.
[16]张晓飞,唐四元.临终关怀教育和培训研究进展.中国老年学杂志,2017,37(9):2333-2336.Zhang XF,Tang SY.Research progress on education and training of palliative care.Chinese Journal of Gerontology,2017,37(9):2333-2336.
[17]缪佳芮,陈柳柳,张江辉,等.晚期癌症患者预立医疗照护计划质性研究进展.医学与哲学,2018(1):61-64.Miao JR,Chen LL,Zhang JH,et al.Advances on qualitative research about Advance Care Planning in patients with advanced cancer.Medicine and Philosophy,2018(1):61-64.
[18]Dixon J,Knapp M.Whose job?The staffing of advance care planning support in twelve international healthcare organizations:a qualitative interview study.BMC Palliative Care,2018,17(1):78.
[19]Narang AK,Wright AA,Nicholas LH.Trends in advance care planning in cancer patients:results from a national,longitudinal survey.JAMA Oncology,2015,1(5):601.
[20]Johnson CE,Singer R,Masso M,et al.Palliative care health professionals'experiences of caring for patients with advance care directives.Australian Health Review,2015,39(2):154.
[21]韩素红,李厚伸,夏丽娜,等.预立医疗照护计划的实践与研究进展.中国护理管理,2018,18(3):298-302.Han SH,Li HS,Xia LN,et al.Implementation and research progress of Advance Care Planning:a review.Chinese Nursing Management,2018,18(3):298-302.
[22]Head BA,Song M,Wiencek C,et al.Palliative nursing summit:nurses leading change and transforming care the nurse's role in communication and Advance Care Planning.Journal of Hospice&Palliative Nursing,2018,20(1):23-29.
[2]Zwakman M,Jabbarian LJ,van Delden J,et al.Advance care planning:a systematic review about experiences of patients with a life-threatening or life-limiting illness.Palliative Medicine,2018(32):1305-1321.
[3]邓仁丽,陈柳柳,史宝欣,等.中国文化背景下预立医疗照护计划的研究进展.中华护理杂志,2015,50(9):1117-1121.Deng RL,Chen LL,Shi BX,et al.Research progress of advanced care planning under Chinese culture.Chin J Nurs,2015,50(9):1117-1121.
[4]国家卫生计生委办公厅.国家卫生计生委办公厅关于印发安宁疗护实践指南(试行)的通知.(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml.National Health Commission of the People's Republic of China.Notice on the issuance of guidelines for the practice of palliative care(pilot).(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml.
[5]国家卫生计生委.国家卫生计生委关于印发安宁疗护中心基本标准和管理规范(试行)的通知.(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/2f50fdc62fa84cdd9d9a09d5162a661f.shtml.National Health Commission of the People's Republic of China,Notice on the issuance of basic standards and management norms for hospice care centers(pilot).(2017-02-09).http://www.nhfpc.gov.cn/yzygj/s3593/201702/2f50fdc62fa84cdd9d9a09d5162a661f.shtml.
[6]关于促进护理服务业改革与发展的指导意见.中国护理管理,2018,18(7):865-867.Guidance on promoti ng the refor m and development of nursing service.Chinese Nursing Management,2018,18(7):865-867.
[7]Lewis K.How nurses can help ease patient transitions to end of life care.Nurs Older People,2013,25(8):22-26.
[8]Hy C,Sm P.Let me talk-an advance care planning programme for frail nursing home residents.Journal of Clinical Nursing,2010,19(21/22):3073-3084.
[9]张汛滔,郭燕,徐晓霞.医护人员对预先指示的态度及其影响因素分析.中国护理管理,2014,14(8):818-822.Zhang XT,Guo Y,Xu XX.Physician and nurses'attitude towards Advance Directives and its influencing factors.Chinese Nursing Management,2014,14(8):818-822.
[10]李宇芳,邹剑莹,骆坚,等.医护患对实施预立医疗照护计划的态度及影响因素调查.护理学报,2014,21(16):21-24.Li YF,Zou JY,Luo J,et al.Attitude of medical staff and patients toward Advance Directives and its influence factors.Journal of Nursing(China),2014,21(16):21-24.
[11]Siu MW,Cheung TY,Chiu MM,et al.The preparedness of Hong Kong medical students towards advance directives and end-of-life issues.East Asian archives of psychiatry:Official Journal of the Hong Kong College of Psychiatrists,2010,20(4):155.
[12]孙振球.医学统计学.3版.北京:人民卫生出版社,2010.Sun ZQ.Medical statistics.3th ed.Beijing:People's Medical Publishing House,2010.
[13]Aguilar-S?nchez JM,Caba?Ero-Mart?Nez MJ,Puerta FNF,et al.Knowledge and attitudes of health professionals towards advance directives.Gaceta Sanitaria,2018,32(4):339-345.
[14]Shepherd J,Waller A,Sanson-Fisher R,et al.Knowledge of,and participation in,advance care planning:a cross-sectional study of acute and critical care nurses perceptions.International Journal of Nursing Studies,2018,86(6):74-81.
[15]Deng RL,Duan JZ,Zhang JH,et al.Advance care planning for frail older people in China:a discussion paper.Nursing Ethics,2018:969733018779177.
[16]张晓飞,唐四元.临终关怀教育和培训研究进展.中国老年学杂志,2017,37(9):2333-2336.Zhang XF,Tang SY.Research progress on education and training of palliative care.Chinese Journal of Gerontology,2017,37(9):2333-2336.
[17]缪佳芮,陈柳柳,张江辉,等.晚期癌症患者预立医疗照护计划质性研究进展.医学与哲学,2018(1):61-64.Miao JR,Chen LL,Zhang JH,et al.Advances on qualitative research about Advance Care Planning in patients with advanced cancer.Medicine and Philosophy,2018(1):61-64.
[18]Dixon J,Knapp M.Whose job?The staffing of advance care planning support in twelve international healthcare organizations:a qualitative interview study.BMC Palliative Care,2018,17(1):78.
[19]Narang AK,Wright AA,Nicholas LH.Trends in advance care planning in cancer patients:results from a national,longitudinal survey.JAMA Oncology,2015,1(5):601.
[20]Johnson CE,Singer R,Masso M,et al.Palliative care health professionals'experiences of caring for patients with advance care directives.Australian Health Review,2015,39(2):154.
[21]韩素红,李厚伸,夏丽娜,等.预立医疗照护计划的实践与研究进展.中国护理管理,2018,18(3):298-302.Han SH,Li HS,Xia LN,et al.Implementation and research progress of Advance Care Planning:a review.Chinese Nursing Management,2018,18(3):298-302.
[22]Head BA,Song M,Wiencek C,et al.Palliative nursing summit:nurses leading change and transforming care the nurse's role in communication and Advance Care Planning.Journal of Hospice&Palliative Nursing,2018,20(1):23-29.