| Summary: | 碩士 === 輔英科技大學 === 護理系碩士班 === 105 === Background: In the Chinese culture, "home" is the result of a person's life, and getting home is the attribution of the value of life. However, medical technology advanced greatly, family try to extend the lives of patients. In the end of patient's life, family and physicians do their best to provide excessive medical intervention. They tend to keep patients in hospital for advanced medical care. In view of excessive use of unnecessary medical measures in terminal care, we should stress the importance of the lack of psychosocial care, family support, and indivisualized management.
Objective: This study aimed to investigate the physiological, psychosocial and spiritual needs of terminally ill patients who receive hospice home care by the action research method. The purpose is to improve the quality of clinical nursing care.
Methods: This study was conducted by the action research method in a metropolitan teaching hospital in Southern Taiwan to investigate terminally ill patients who receive hospice home care. By means of participating observation, chart review, and qualitative research questionnaires, we learned terminally ill patients' physiological, psychosocial and spiritual problems and the grief of bereaved family. We formulate a algorithm improve the preparation of a good death for terminally ill patients. Then we take action and evaluate the effects.
Results: We reviewed medical records of 70 patients who receive hospice home care to understand pre-dying symptoms, incluing change of vital signs, breath with mouth open, weakness, upward gaze, incontinence, cyanosis.
Psychosocial and spiritual care focus on nearing death awareness. During the course of action research, we evaluated the symptoms of the pre-dying patients, and then integrate the symptoms difficult to access by hospice nurse and follow-up of the bereaved family.
Conclusion: In the action research circle, the researcher also carry out evaluation and implementation of the preparation of a good death for pre-dying patients who receive hospice home care. The resercher can
understand better the needs of terminally ill patients and the grief of bereaved family. Furthermore, we can provide more appropriate care planning and preparation for a good death.
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