近年来我国安宁疗护服务发展迅速，覆盖范围逐渐扩大，并取得初步成效，但各地区实践差异较大，有待进行系统、全面的总结分析。本文基于实施性研究的整合性理论框架从创新、外部环境、内部环境、个体特征、实施过程5个方面全面分析并总结安宁疗护服务的实施现况，发现促进该服务实施的主要因素为服务项目种类多且个性化、积极开展培训工作、多学科团队分工明确、服务模式多元化、重视服务的宣传工作等。服务面临的主要挑战为内外部激励措施不足、人力及药品可用资源不足、服务提供者知信行水平有待提升、服务流程有待统一、质量评价体系有待完善等。各级有关机构应联动起来，发挥促进因素的积极作用，克服阻碍因素，进一步推动我国安宁疗护的发展。 A rapid growth and steady expansion has been witnessed in hospice care with initial effects in recent years, however, there are significant differences in practice among different regions, and a systematic and comprehensive summary and analysis are needed. Based on the consolidated framework for implementation research, this paper comprehensively analyzes and summarizes the implementation status of hospice care services from five aspects, including innovation, external setting, internal setting, individual characteristics and implementation process. This paper finds that the main factors contributing to the implementation of this service are the varied and individualized services, active implementation of training, clear division of labor among multidisciplinary teams, diversified service models, and emphasis on service publicity. The main challenges faced by the service are insufficient internal and external incentives, insufficient resources available for manpower and medicines, the level of knowledge, attitude, and practice of service providers needs to be improved, the service process needs to be harmonized, and the quality evaluation system needs to be improved. Relevant institutions at all levels should work together to play a positive role in facilitating factors, overcome obstacles, and further promote the development of hospice care in China.
Abstract
A rapid growth and steady expansion has been witnessed in hospice care with initial effects in recent years, however, there are significant differences in practice among different regions, and a systematic and comprehensive summary and analysis are needed. Based on the consolidated framework for implementation research, this paper comprehensively analyzes and summarizes the implementation status of hospice care services from five aspects, including innovation, external setting, internal setting, individual characteristics and implementation process. This paper finds that the main factors contributing to the implementation of this service are the varied and individualized services, active implementation of training, clear division of labor among multidisciplinary teams, diversified service models, and emphasis on service publicity. The main challenges faced by the service are insufficient internal and external incentives, insufficient resources available for manpower and medicines, the level of knowledge, attitude, and practice of service providers needs to be improved, the service process needs to be harmonized, and the quality evaluation system needs to be improved. Relevant institutions at all levels should work together to play a positive role in facilitating factors, overcome obstacles, and further promote the development of hospice care in China.
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