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Líknarmeðferð fyrir sjúklinga með langvinna lungnateppu: Að vera samstíga

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Authors
Guðrún Jónsdóttir
Helga Jónsdóttir
Issue Date
2016

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Other Titles
Palliative care for COPD patients: synchronized care
Citation
Tímarit hjúkrunarfræðinga 2016, 92(3):12-20
Abstract
Bakgrunnur og tilgangur: Tilgangur rannsóknar var að lýsa reynslu og viðhorfum hjúkrunarfræðinga á líknarmeðferð og innleiðingu hennar á sjúkradeild til þess að styrkja þjónustu við sjúklinga með langvinna lungnateppu. Slík innsýn gæti bætt lífsgæði sjúklinga með langvinna lungnateppu og fjölskyldna þeirra sem standa andspænis lífhættulegum sjúkdómi. Fræðilegur bakgrunnur var óvissulíkan Roland van Linge. Þar er gert ráð fyrir að árangursrík innleiðing þurfi samþýðanleika milli nýjungar (líknarmeðferðar lungnasjúklinga) og umhverfis eða núverandi starfshátta. Aðferð: Tekin voru tvö rýnihópaviðtöl við hjúkrunarfræðinga (N=8) á lungnadeild Landspítala – háskólasjúkrahúss sem þjóna hlutverki greiningarviðtals í innleiðingunni. Greindar voru hindranir og árangursríkar leiðir fyrir innleiðinguna. Niðurstöður: Þemagreining sýndi að meginhindranir við innleiðingu líknarmeðferðar voru hugtakaruglingur varðandi líknar- og lífslokameðferð, hjúkrunarfræðingana greindi á við aðrar heilbrigðisstéttir, m.a. lækna um framkvæmd líknarmeðferðar, auk þess sem óvissa um framgang sjúkdóms gat hindrað ákvarðanatöku um meðferðina. Árangursríkar leiðir til innleiðingar vörðuðu mikilvægi þess að vera samstiga varðandi framkvæmd líknarmeðferðar og í því samhengi voru þverfaglegir vinnufundir mikilvægir þar sem fagstéttirnar gætu unnið sameiginlega að meðferðarmarkmiðum. Ályktanir: Til þess að geta veitt sjúklingum með langvinna lungnateppu líknarmeðferð þarf sérhæfingu þar sem um flókinn sjúkdóm og sjúkdómsferli er að ræða. Við innleiðingu á klínískum leiðbeiningum um líknarmeðferð þarf að byggja á þekkingu um sérstakar þarfir lungnasjúklinga; innleiðing þarfnast tíma og fjármuna og hugsanlega þarf að laga leiðbeiningarnar að sértækum þörfum þessa skjólstæðingahóps.
Background and aim: The aim of the study was to describe and explore nurses’ experience of using palliative care and the implementation of clinical guidelines for palliative care in a pulmonary hospital unit for the purpose of improving healthcare for patients with chronic obstructive pulmonary disease (COPD). Insight into this experience might improve quality of life of patients and their families who face problems associated with this life-threatening disease. Theoretical background is the contingency model by Roland van Linge. In the model effective implementation consists of congruency between the intervention (palliative care) and the environment or existing practice. Method: In this qualitative research two focus group interviews were carried out with nurses (N=8) at a pulmonary unit at Landspitali National University Hospital, as key informants, where facilitators and barriers for the implementation of palliative care were identified along with elucidating the nurses’ experience. Results: The themes that were analyzed were confusion of concepts as regards palliative care and end-of-life care, that nurses were in conflict with other health care professionals, e.g. physicians, about how to apply principles of palliative care in the unit as well as uncertainty of the course of the disease as hindering decision making about palliative care. Successful implementation was considered likely when health care workers work together as a team. Conclusion: There is need for specialized palliative care for patients with COPD due to the complexity and nature of the course of the disease. Implementation of clinical guidelines in palliative care for patients with COPD needs to be based on specialized knowledge of the lung disease; it takes time and resources, as well as amendments to the special needs of this patient group.
Description
Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn
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http://hjukrun.is/library/Skrar/Timarit/Timarit-2016/3-tbl-2016/Liknarmedferd.pdf
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Icelandic Journal Articles (Peer Reviewed)

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