【作者】 刘丹；

【导师】 任杰慧；

【作者基本信息】 河北大学 ， 社会工作硕士（专业学位）， 2024， 硕士

【摘要】 随着医学技术的发展和生命质量的提高,“死亡质量”也日益被重视。2021年发布的《中国老年健康和家庭幸福影响因素跟踪调查》报告发现,临终阶段的老年人临终前生活大多不能完全自理,身体健康状况堪忧,所接受的照料多是非专业性服务,为了微不足道的治疗效果和延长生命时限,选择更大痛苦的被动治疗来维持生命,让患者的临终生活惨不忍睹。提高临终期老年人的生命质量深刻影响着老年人生命的整体质量,倡导接受安宁疗护服务,值得全社会关注。除了社会层面的国家政策的普及宣传,还需要社会工作者从老年人本身出发,对其进行安宁疗护的知识教育和全面宣传。本研究以衡水市X社区老年人为研究对象,对X社区老年人的安宁疗护认知水平进行问卷调查发现,X社区老年人安宁疗护认知水平较低,有一定的生命质量提升意识,但是没有了解过安宁疗护,因此也影响他们对安宁疗护服务的接受度。通过访谈深入了解之后,发现X社区老年人普遍有认识安宁疗护的需求和扩大社会支持网络的需求。由此,社会工作者采取小组工作方法,开展8节宣传教育小组活动,帮助老年人改变对死亡的看法,认识到死亡质量的重要性,全面了解安宁疗护,并且关注建构家人和朋友这一亲密的情感的非正式社会支持网络,了解安宁疗护正式服务的各专业的功能和作用发挥。此外,在情景剧模拟扮演和社区宣传中,不断加强老年人对安宁疗护的深度信任,最后,老年人自愿选择在患癌症或者重病晚期接受安宁疗护服务。整个小组活动介入过程运用知信行的理论和实践思路,本研究得出,安宁疗护知识的宣传是整个社会生命质量提高的前提,小组工作介入安宁疗护认知提升有一定现实意义,让老年人真正提升安宁疗护认知水平,关注生命质量。更多还原

【Abstract】 With the development of medical technologies and quality of life improvement,the“quality of death” has attracted more and more attention.Based on tracking survey data on influencing factors of elderly health in China from 2002 to 2018,the current situation of mortality quality among the elderly at the micro level in China has been analyzed.The survey result indicates that most elderly in the terminal stage cannot fully take care of themselves before their death,and their physical health is worrying.The care they receive is mostly provided by non-professional institutions or individuals.For the sake of negligible therapeutic effects,a more painful and active treatment is chosen to maintain vital signs,causing miserable pain to patients during the terminal stage.Improving the quality of life for the elderly in the terminal stage profoundly affects the overall quality of their lives.It is no longer just about focusing on the duration of life and passive treatment of diseases for the elderly,but gradually forming a new concept of health to seek quality of life in the final stages of life.Therefore,advocating for accepting hospice care services is worthy of society’ s attention as well.In addition to the dissemination and promotion of national policies at the societal level,it also requires social workers to start with the elderly themselves,providing them with knowledge education on hospice care,and comprehensive promotion.Taking the elderly in Community X of Hengshui City as the research subjects,the scale method and interview method were utilized to investigate the project.A scale survey on the cognitive level of hospice care awareness among the elderly in Community X revealed that their cognitive level is relatively low,with some awareness of improving quality of life,but they lack understanding of hospice care,affecting their acceptance of hospice care services.Through in-depth interviews,it was found that the elderly in Community X generally have the need to understand hospice care and the need to expand their social support network.In response to the current cognitive status and needs assessment of hospice care among the elderly mentioned above,social workers decided to implement group work by conducting 8sessions of educational group activities.During the group activities promoting hospice care education,social workers helped the elderly change their views on death,recognize the importance of the quality of death,gain a comprehensive understanding of hospice care,and focus on building informal social support networks with family and friends,understanding the functions and roles of various professional services in hospice care.Furthermore,through role-playing in scene play and participating in community outreach,the trust of the elderly in hospice care was continuously strengthened,and eventually,the elderly voluntarily chose to receive hospice care services when suffering from cancer or in the terminal stage of a serious illness.The entire process of group activity intervention utilized the theory and practical thinking of knowledge-attitude-practice.The author realized that promoting knowledge of hospice care is a prerequisite for improving the overall quality of life in society.Therefore,the intervention of group work in enhancing awareness of hospice care has certain practical significance,allowing elderly people to truly improve their level of hospice care awareness and focus on quality of life.更多还原