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中文摘要: 目的 通过舒缓疗护护理日志采集和分析，了解社区舒缓疗护服务现况，为完善服务内容，提高舒缓服务质量奠定基础。方法 于2016年11月至12月，采集迎博社区卫生服务中心近两年（2014年11月至2016年7月）记录的舒缓疗护护理日志。数据分析是在SPSS19.0和Excel2016下进行，主要采用描述性分析方法。结果 本次采集护理日志共77份，每篇护理日志对应一位患者及患者家属。护理日志分析结果显示：患者平均年龄为75±12.0岁；癌症患者占比97.40%（75/77）；KPS评分为50±9.0分；49例（63.6%）患者预期生存期在一个月以内，其预期生存期中位数为22天（四分位数间距为4.5天，范围为8～27天）；住院天数中位数为12天（四分位数间距为30天，范围为1～84天）。对于患者支持的态度显示，多数患者家属强调要减轻患者痛苦（58人，75.3%）和提高患者生命质量（43人，55.8%）。患者呈现的问题，主要是实验室指标异常、皮肤问题、疼痛、自理能力缺失、呼吸困难，以及谵妄等躯体症状和心理问题。社区在居住环境、满足临终心愿、宗教信仰关怀、灵性关怀等方面提供了一定的支持，并对患者家属提供了哀伤辅导，化解了家庭矛盾。结论社区舒缓疗护服务对象以中老年癌症晚期患者为主，服务内容设置全面，但是社区舒缓疗护护理日志尚未实现标准化，因此，舒缓疗护的服务对象有待进一步延展，服务质量还有待提升，护理日志撰写函待进一步规范。
Abstract:Objective To investigate the current situation of palliative care in community through the collection and analysis of nursing logs, so as to lay the foundation for improving the palliative care service content and its quality.MethodsPalliative care nursing logs was collected from the community health service center for nearly two years (November 2014 - July 2016) from November 2016 to December 2016, Data analysis was carried out under SPSS19.0 and excel2016, and descriptive analysis was adopted.ResultsThere were totally 77 nursing records, and each nursing log was corresponding to one patient and the patient's family. Nursing log analysis showed that: the average age of the patients was 75 + 12 years; cancer patients accounted for 97.40% (75/77); the KPS score was 50 + 9; 49 cases (63.6%) were expected to survive within one month, the life expectancy was at a median of 22 days (four percentile interval for 4.5 days, ranging from 8 ~ 27 days); the median duration of hospitalization was 12 days (the four percentile interval was 30 days, ranging from 1 to 84 days). The patient support attitude showed that most of the patients’ family pressed for alleviating the patient’s pain (58, 75.3%) and improving their quality of life (43, 55.8%). The main problems of the patients were somatic and psychiatric symptoms, such as abnormal laboratory indexes, skin problems, pain, lack of self-care ability, dyspnea, delirium and so on. The community has provided certain support in the living environment, the satisfaction of the dying wish, the religious care and spiritual care, and provided grief counseling for the family members of the patients, and thus resolving the family conflicts.ConclusionCommunity palliative care mainly provides comprehensive service to the elderly patients with advanced cancer, but the community palliative nursing logs have not yet been standardized. Therefore, the palliative care service object needs to be further extended, the service quality remains to be improved, and the written of nursing logs needs to be further standardized.
keywords: Palliative care Nursing logs Community
文章编号：3201712037 中图分类号：R1-9 文献标志码：
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