【摘要】 目的:癌症患者家属是患者的重要社会支持系统,有效的信息支持可以帮助其更好地应对应激原,减轻心理压力。通过对临终癌症患者家属和相应病房的护士就有关信息支持情况的调查分析,以便为一线肿瘤临床医护人员了解和满足临终癌症患者家属的需求,并指导其在临床实践中与家属进行更有效的交流沟通。方法:于2004-03采用方便取样方法选取北京市某三级甲等肿瘤医院临终癌症患者的家属且愿意参加此次调查者35人和患者所在病房的相应护士29人,进行《临终癌症患者家属信息需求问卷》和《护士给予家属信息调查问卷》问卷调查。2个问卷中均包括答卷者一般资料和5大类(①治疗用药信息。②检查检验信息。③如何护理患者信息。④医院流程和收费信息。⑤家属心理和社会支持信息)30项信息的需求程度调查。家属问卷还涉及到信息获得途径、对信息获得方式的选择等内容。护士问卷包括了护士给予信息的情况及相关态度等。均按照“非常需要”、“需要”、“无所谓”、“不需要”给予评定,依次赋值4～1分。结果:发放家属问卷35份,收回合格问卷35份,有效率100%。发放护士问卷29份,收回合格问卷29份,有效率100%。①家属在不适症状的缓解、使用药物的作用、检验检查结果方面的信息需求程度高于护士的评定。而护士在化疗致恶心呕吐的缓解、化疗中如何防止和发现药物外渗的方法评定分数高于家属,差异均有显著性意义。②医生均以较高比例被家属作为首选信息获得途径。③护士在临床工作中给予家属详细的信息包括:化疗中如何防止和及时发现药物外渗的方法;如何正确评估患者疼痛等级;长期卧床患者的皮肤护理方法;止疼药物的正确使用方法及局部静脉红肿的处理方法。④在信息给予方式的选择中,家属选择最高为“医生主动询问并讲解”穴76人次,74%雪;“家属未主动询问”和“无人提供”是家属未获得信息的主要原因。结论:护士与家属对于信息的主观选择形成了“选择性心理干扰”。即影响了家属对护士提供信息的理解也影响了护士对家属信息需求的判断。临床护理人员在讲明信息的重要性,并取得家属的重视后,才会有理想的信息交流结果。患者和家属对医生的信任度和依从性远远高于护士。加强护士沟通培训,以提高临床护士的信息交流水平及其地位和作用。更多还原

【Abstract】 AIM: The families of the cancer patients are the important social support system of patients. Efficient information support could help their families to deal with stress, and relieve psychological pressure. In this paper, we investigated and analyzed the information related to the families of cancer patients and their nurses to make the clinical oncologists and nurses understand and satisfy the needs of the family members of the terminal patients, and better the communication between the doctors and nurses and the family members of terminal patients. METHODS: With the convenient sampling method, 35 family members of the terminal cancer patients and 29 nurses from the corresponding wards in some Tumor Hospital at First Class of Third level in Beijing were selected in March 2004 for questionnaire investigations of "Information Demand Questionnaire of Family Members of Terminal Cancer Patients" and "Information Questionnaire for the Families of Patients Given by Nurses". The two questionnaires included general data and 5 sorts of 30 items: Medicinal information. ②Examination information. ③Information about nursing. ④Information about hospital procedure and cost. ⑤Information about family psychology and social support. The family member questionnaire also involved the information obtained pathway, selection of obtaining and so on. The nurse questionnaire referred to the information and attitude of nurses. All the questions were graded by 4-1 according to "necessary demand", "demand", "unnecessary" and "not demand".RESULTS: Thirty-five questionnaires were sent out and 35 valid ones were retrieved with the efficient rate of 100%. Twenty-nine sheets were given to the nurses and all were retrieved with the efficient rate of 100%. The information that the demand of the family members on the relief of symptoms, effect of medicine and results of examination was far more higher than what the nurses assessed. On the other hand, nurses did much better than the families in the relief of vomit caused by chemotherapy, prevention and discovery of medicine exosmosis during chemotherapy, and the differences were significant. ②Doctors were selected firstly to acquire information by the family members of patients. ③The detail information the nurses given to the families included the prevention and discovery of medicine exosmosis during chemotherapy; correct evaluation of the pain degree of patients; skin nursing care for long-term bed patients; correct methods to take medicine and handling of local vein flare. ④In the option of information given, "subjective inquire and explanation of doctors" were most selected by the members (76 man-time, 74%); "without subjective inquire" and "unavailable" were the main reasons for the family member not obtained the information. CONCLUSION: The subjective choices of nurses and families of patients render a "selective psychological interfere", which influences both the understanding about the information provided by nurses and the judgments of nurses about the information demanded by the families. If the clinical nursing staff can explain the importance of nursing information and obtain the emphasis of patients’ families, there will be an ideal communication result. Since patients and their families believe in and reliance on doctors much more than the nurses, it is important to strengthen the communication training of nurses, so as to enhance their ability in information communication and gradually improve their status and roles.更多还原