Abstract:

Objective To improve quality of death outcomes of patients with terminal tumors in palliative care demonstration ward. Methods Totally 69 patients with terminal tumor admitted to the Anxin ward were randomly divided into two groups（the control group and the experimental group） by random number table method. Both groups were evaluated,planned,and provided with symptom management of Chinese medicine and caring time,and evaluated for spiritual care by a hospice care team including medical workers. The experimental group had cancer volunteers participating in the“Reading the Classics of Sinology”,“Meeting a Wish”,“Voice of the Mind Theme Event” and “Festival Culture” activities. The patients’ quality of life,spiritual well-being and anxiety and depression were evaluated by FACT-G,FACT-Sp-12 and HAD. Results Patients in the experimental group had significant better scores in social/family status dimensions of quality of life,spiritual comfort,anxiety and depression than patients in the control group（P<0.05）. There were no differences in three dimensions of quality of life （physical condition,emotional condition,and functional condition） and total score for quality of life between two groups（P>0.05）. Compared with those before intervention,quality of life,spiritual comfort,anxiety and depression in two groups were significantly different（P<0.05）. Conclusion Compared with the group composed entirely of medical workers,the activities of palliative care with participation of cancer volunteers can better improve high quality death of patients with terminal tumors.

Key words: Carcinoma, Volunteer, Hospice Care, High Quality Death, Nursing Administration Research, Randomized Controlled Trial

摘要：

目的 组织康复期癌症志愿者参加晚期癌症患者安宁疗护,改善入住安宁疗护示范病房的晚期癌症患者的优质死亡结局。方法 采用随机数字表法将入住安宁疗护示范病房的69例晚期癌症患者随机分成试验组和对照组,康复期癌症志愿者参与试验组的安宁疗护活动,活动内容包括读国学经典、满足1个心愿、心灵的声音主题活动、节日家文化等。两组都由医务工作者组成的安宁疗护小组给予病情评估、安宁疗护计划、中医症状管理、灵性照护之关爱时间等干预措施。采用肿瘤患者生活质量综合评价量表、灵性安适量表和综合性医院焦虑抑郁量表评价两组的生活质量、灵性安适程度和焦虑抑郁情绪。结果 试验组在生活质量的社会/家庭状况维度、灵性安适程度和焦虑抑郁情绪方面都优于对照组,差异均有统计学意义（均P<0.05）;而试验组生活质量的身体状况、情感状况、功能状况3个维度和生活质量总分与对照组比较,差异无统计学意义（均P>0.05）。与干预前比较,干预后两组生活质量、灵性安适程度、焦虑抑郁情绪差异均有统计学意义（均P<0.05）。结论 相比于完全由医务工作者组成的安宁疗护小组,有康复期癌症志愿者参与的安宁疗护活动,能更好地改善晚期癌症患者的优质死亡结局。

关键词: 癌, 志愿者, 安宁疗护, 优质死亡, 护理管理研究, 随机对照试验