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首页> 外文学位 >EiBarriers among primary care providers to utilizing palliative/hospice care for patients with non-cancerous terminal illness.
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EiBarriers among primary care providers to utilizing palliative/hospice care for patients with non-cancerous terminal illness.

机译：初级保健提供者中的EiBarriers对于非癌性绝症患者采用姑息治疗/临终关怀治疗。

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摘要

Patients with terminal illness may benefit greatly from hospice and palliative care. Studies of patients with chronic terminal illness revealed that those who did not received palliative or hospice care experienced poor quality medical care characterized by untreated symptoms, unmet spiritual and personal care needs, increased burden for the caregiver, and low patient and family satisfaction (Meier, 2011). According to the World Health Organization (2011), palliative care is offered at the time of diagnosis alongside potentially curative treatment and can be utilized during the trajectory of illness until death. Hospice is a Medicare benefit considered the model for quality, compassionate care during the last 6 months of life and is available to all patients regardless of age, religion, race, or illness (Medicare Hospice, 2011).;This study examined why patients with non-cancerous terminal illness were not receiving timely palliative or hospice care by interviewing primary care providers.;A systemic literature review suggested possible barriers including confusion between palliative and hospice care, lack of understanding about the scope and intent of hospice care (McAteer & Wellberry, 2013), prognostic uncertainty, timing, and no clear point to originate a referral (LeMond & Allen, 2011). Insufficient training for primary care providers, including the lack of familiarity with various prognostic tools that aid in determining eligibility for the patient with a non-cancerous, terminal diagnosis might also be a barrier to referral (McAteer & Wellberry, 2013). Lastly, primary care providers lacked confidence in communicating the need for advanced care planning in non-cancerous terminal illnesses according to a survey done by Karlekar, Collier, Paish, Olson, & Elsay (2014).;The findings of this study confirmed the available literature. Much work is needed to educate providers and incorporate palliative care and hospice guidelines in academic institutions and in practice. Regulatory issues need continuous attention as the landscape of coverage, payment, and reimbursement changes rapidly. Further research is needed so that this vulnerable population will benefit from early interventions and a better understanding and acceptance of their non-cancerous terminal illness.
机译：绝症患者可以从临终关怀和姑息治疗中受益匪浅。对患有慢性末期疾病的患者的研究表明，那些未接受姑息治疗或临终关怀治疗的患者所经历的医疗质量较差，其特征是症状未得到治疗，精神和个人护理需求未得到满足，护理人员的负担增加以及患者和家庭满意度低（Meier， 2011）。根据世界卫生组织（2011年），在诊断时提供姑息治疗以及可能的治愈性治疗，并且可以在疾病的发展过程中加以利用，直至死亡。临终关怀是一种医疗保险福利，被认为是生命的最后六个月中优质，富有同情心的护理的模型，并且无论年龄，宗教信仰，种族或疾病，所有患者都可以使用临终关怀（Medicare Hospice，2011年）。非癌症末期疾病未通过与初级保健提供者进行访谈而得到及时的姑息治疗或临终关怀治疗。;系统文献综述显示可能的障碍包括姑息治疗和临终关怀治疗之间的混淆，对临终关怀治疗的范围和意图缺乏了解（McAteer＆Wellberry） （2013年），预后的不确定性，时机选择和明确的转介点（LeMond＆Allen，2011年）。对初级保健提供者的培训不足，包括对有助于确定非癌性，终末诊断患者资格的各种预后工具的不熟悉，也可能是转诊的障碍（McAteer＆Wellberry，2013）。最后，根据Karlekar，Collier，Paish，Olson和Elsay（2014）进行的一项调查，基层医疗服务提供者对传达非癌性绝症的高级护理计划的需求缺乏信心。文献。要教育提供者并在学术机构和实践中纳入姑息治疗和临终关怀指南，需要做大量工作。监管问题需要不断关注，因为承保范围，付款和报销的格局正在迅速变化。需要进一步的研究，以便使这些弱势人群能够从早期干预措施中受益，并更好地理解和接受他们的非癌性绝症。

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  • 作者

    Ellis, Susan Eileen.;

  • 作者单位

    The University of Arizona.;

  • 授予单位 The University of Arizona.;
  • 学科 Nursing.;Health care management.
  • 学位 D.N.P.
  • 年度 2016
  • 页码 52 p.
  • 总页数 52
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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