摘要
目的 基于利益相关者理论,探讨安宁疗护的需求者、实施者和管理者对安宁疗护护理管理优先事项及促进和障碍因素.方法 采用描述性质性研究方法,选取2022年5-12月在南京市某安宁疗护试点单位接受治疗的的患者、照护者进行访谈,并对南京市5家安宁疗护试点单位中工作的部分护士、医生和负责人进行半结构式访谈,运用Colaizzi 7步法对访谈资料分析、归纳和提炼主题.结果 提炼出3个主题和10个亚主题.(1)安宁疗护护理管理的优先事项(合理定位、及时沟通、症状管理相关疗护项目、环境与氛围设计).(2)安宁疗护护理管理的内部促进和障碍因素(涉及多种类劳动、能力因素、教育与培训).(3)安宁疗护护理管理的外部促进和障碍因素(责权法律因素、政策因素、资金因素).结论 本研究结果对于开展安宁疗护服务有实际的借鉴作用.管理者可以通过不同利益相关者了解安宁疗护护理管理的优先事项及促进和障碍因素,且有必要制定安宁疗护护理管理质量标准,推动我国安宁疗护服务管理规范化.此外,发展安宁疗护教育、完善相关法律法规有利于安宁疗护的长久管理.
Abstract
Objective To explore the perspectives of demanders,implementers,and managers of hospice care on the priorities,promotion,and obstacles of hospice care management based on stakeholder theory.Methods The de-scriptive research method was used to select patients and caregivers who received treatment in a hospice pilot unit in Nanjing from May to December 2022 for interviews.Semi-structured interviews were conducted with some nurses,doctors,and leaders working in 5 hospice pilot units in Nanjing.The interview data was analyzed,summarized,and extracted by Colaizzi's 7-step method.Results The results extracted 3 themes and 10 sub themes.(1)Priorities for hospice care management(reasonable positioning,timely communication,symptom management related care pro-jects,environment and atmosphere design).(2)The internal promotion and obstacle factors of hospice nursing man-agement(involving multiple types of labor,ability factors,education and training).(3)The external promotion and obstacle factors of hospice nursing management(legal factors,policy factors,and financial factors).Conclusion The results of this study have practical reference value for carrying out hospice care services.Managers can understand the priorities,promotion,and obstacles of hospice care management through different stakeholders.It is necessary to establish quality standards for hospice care management and promote the standardization of hospice care service management in China.In addition,developing hospice education and improving relevant laws and regulations are beneficial for the long-term management of hospice care.
基金项目
国家自然科学基金项目(71704084)
江苏省老年健康重点课题项目(LKZ2022002)
江苏省人民医院"临床能力提升工程"护理项目立项重大课题项目(JSPH-NA-2021-1)
江苏省研究生科研与实践创新计划项目(SJCX22_0701)
维普
万方数据