在重症监护病房识别患者姑息治疗需求的困境

Nining Puji Astuti, S. Sriyono, E. Yunitasari, Ninuk Dian Kurniawati, Arief Shofyan Baidhowy
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引用次数: 0

摘要

姑息关怀是从重病诊断开始,直到死亡和丧亲关怀为止。但是,"姑息关怀 "一词常常被误认为等同于没有任何治疗的 "生命末期关怀"。 这让护士们左右为难,是最大限度地满足姑息关怀的需求,还是让病人得到最低限度的关怀。方法:本文旨在评估重症监护病房姑息关怀需求的两难处境。这是一份病例研究报告,采用定性方法对重症监护病房的 3 名姑息治疗患者进行了描述性病例研究,并对患者家属、护士和内科医生进行了深入访谈。结果与讨论:我们报告了 3 名癌症患者的病例,他们入院后需要在重症监护室接受姑息治疗。患者随后出现肺转移和多器官衰竭。然而,临终病人生命末期护理的目标是在尊重病人意愿的前提下,尽可能预防或减轻痛苦。但在印尼,尤其是重症监护室的姑息治疗患者,这仍然是一个两难问题。根据医学决定,重症监护病房的病人应接受最大限度的治疗,但如果病人面临多器官衰竭,护士则应考虑提供姑息治疗。结论在重症监护病房内采用姑息治疗方法和提供姑息治疗,可显著影响护理效果,提高生命末期患者的生活质量。姑息关怀不会减少药物剂量和病人护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dilemma of Identification Patients Palliative Care Needs in Critical Care Unit
Palliative care is start from diagnosis of serious illness until death and bereavement care. But, the term “Palliative Care” often mistakenly regarded identical to “End of Life Care” without any treatments.  It’s caused dilemma among nurses to give maximum care of palliative care needs or let the patients get minimum of care. Methods: The aim of this article is to evaluate the dilemma palliative care needs in Intensive Care Unit. This is a case study report used a qualitative approach of 3 palliative patients in ICU used descriptive case study as well as in depth-interviews with patient’s family, nurses and internist. Results and Discussion: We present a case report of 3 patient who had been admitted to hospital with cancer and need palliative care in ICU. Patients subsequently suffered a pulmonary metastase with multiple organ failure. However the goal of end of life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patient’s desires. But it is still a dilemma in Indonesia, especially palliative patients in ICU. According to medical decision, patients in ICU should receive maximum treatment, but if patient is facing multiple organ failure nurse should consider to providing palliative care. Conclusions: Palliative care approaches and provision within intensive care units can significantly impact care outcomes and increase the quality-of life people with end-of life period. Palliative care not to reduce the dose of drugs and patient care.
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