华中科技大学
硕士学位论文
生命末端的关怀期望研究
姓名：吴辉
申请学位级别：硕士
专业：护理学
指导教师：曾铁英
2010-05
生命末端的关怀期望研究
爱的风铃中文摘要
盗汗是什么原因目的：
了解中国文化背景下人们对善终的期望现状，分析不同人群对善终认识和需求的差异，并探索人们对善终期望差异的影响因素，为更好地改善临终生命质量、提升临终关怀服务提供理论依据。
方法：
本研究运用文献分析法、焦点小组访谈法等确定生命末端关怀期望调查问卷表；采用便利抽样法，对湖北省、北京、上海等三级甲等综合性医院的护理实习生（护生）、医护人员及普通人群共750名进行现场调查。对收集的数据采用EpiData3.1双录入法进行资料的录入，用软件SPSS15.0进行数据分析。分析包括描述性统计分析、Wilcoxon 检验或Kruskal -Wallis检验、单因素Logistic回归分析、多因素非条件Logistic回归分析、因子分析、信度分析等。全部检验均为双侧检验，p值＜0.05时有统计学意义。结果：
1 护生认为好死最重要的是“有家人的支持”93.0%（4.40分）、“与想见的人见面”92.5%（4.34分）、“与护士融洽相处”4.01分；而“没有疼痛”的认同率仅69.9%（3.72分）、“没有连接医学仪器或管道”仅51.6%（3.52分）。处置死亡患者经历、危重患者接触史、文化程度、家庭所在地、丧亲经历等因素对护生的善终期望评分有一定影响（P＜0.01或P＜0.05）。
2 医护人员对“没有疼痛”的赞同率达95.7%（4.33分）、对“没有接受过度的治疗”以及“自然死亡”的不赞同率仅为5.9%（3.82分）、3.4%（3.99分）。患严重疾病经历、
危重患者接触史、科室、职业、性别等因素对医护人员的善终期望评分有一定影响（P ＜0.01或P＜0.05）。
不用客气英文
3 普通人群对“没有连接医学仪器或管道”和“没有接受过度的治疗”的赞同率为50.5%（3.47分）、60.5%（3.63分）；对“知道自己预计生存期还有多长”和“知道将来自己的病情会如何”的赞同率为55.3%（3.54分）、61.1%（3.65分）。患严重疾病经历、危重患者接触史、文化程度、年龄、家庭所在地等因素对普通人群的善终期望评分有一定影响（P＜0.01或P＜0.05）。暗恋是什么感觉
吃饭英语怎么说4 护生、医护人员、普通人群对量表核心项中的“获得个人尊重”、“环境舒适”、“良好的家庭关系”、“良好的医患关系”、“独立自理”、“维持希望和快乐”等的评分均在4分以上，均被视为实现善终的重要经历；而“人生使命的完成”的评分均在4分以下。
5 护生、医护人员、普通人群对量表可选项中的“临终前的准备”包括“与想见的人见面”、“对周围的人心存感激”、“能够向亲人说出自己的需求”的评分均达到4分以上。结论:
1 护生对好死期望关注更多的是在心理、社会需求上，而对更基本的生理层面上的需求认识仍显不足，医科院校需重视对学生的生死教育，引导学生对生命的深入思考。
2 医护人员更崇尚自然生命。不是盲目地进行无意义地延长患者生命，减轻对家庭的经济负担，并提倡合理利用公共卫生资源。
3 因势利导、因人而异地开展科学的死亡教育是增强医护人员对生死观认识的可探索途径。
4 重视对普通人群的死亡教育，鼓励他们树立正确、科学的死亡观。
5 人们对善终的期望主要表现在：有良好的家庭关系和医患关系、态度乐观坦然、无痛苦、有尊严、平静、独立自理地在喜爱的地方逝去。
关键词：
好死善终临终关怀生命质量死亡观
Study On Good Death
Abstract
Objectives
Find out the current situation of people’s expectation of good death under the background of Chine culture. Analyze the difference of different people’s awareness and demand to good death. Explore the impact factor of the expectation of good death. To provide a theoretical basis for improving the quality of dying life and promoting rvices of Hospice Care.
Methods
Bad on literature review and focus groups, the rearch had established the Survey questionnaire of the expectation of Hospice Care. Using Convenient Sampling, 750 nursing interns, medical stuff and general population had been investigated in Third Grade Class General Hospital in Hubei, Beijing, Shanghai. The data was recorded with software EpiData3.1, double-entry method and analyzed with SPSS15.0 software. Analysis included general statistic descriptive analysis, Wilcoxon test or Kruskal-Wallis test, single-factor Logistic Regression Analysis, Multi-factors Non-condition Logistic Regression Analysis, Factor Analysis and Correspondence Analysis, etc. All tests were double-tailed tests and it indicates a statistic significance when р＜0.05.
Results
男人电影
1 Nursing interns considered that the most three important factors were “the support of family” which had agreed rate 93.0% (4.4), “eing the desired person” 92.5% (4.34), “harmony with nur” 4.01. However, the agreed rate of “no pain” was 69.9% (3.72), “no medical instruments or tubes” 51.6% (3.52). Experience of death disposal, history of caring critical ill patient, education, houhold location, experience of bereavement were
predictors of nursing interns’ expectation of good death (P＜0.05 or P＜0.01).
日本写真美女
2 Medical stuff considered that the agreed rate of “no pain” was 95.7% (4.33), the disagreed rate of “no over treatment”, “natural death” was only 5.9% (3.82) and 3.4% (3.99). Experience of rious illness, history of caring critical ill patient, department, occupation and gender were predictors of medical stuffs’ expectation of good death (P＜0.05 or P＜0.01).
3 General population considered that the agreed rate of “no medical instruments or tubes” and “no over treatment” were 50.5% (3.47), 60.5% (3.63); the agreed rate of “awareness of expected life span” and “awareness of one’s life expectancy” were 55.3% (3.54), 60.5% (3.65). Experience of rious illness, history of caring critical ill patient, education, age and houhold location were predictors of general populations’ expectation of good death (P＜0.05 or P＜0.01).
4 Nursing interns, medical stuff and general population considered that “being respected”, “environmental comfort”, “good relationship with family”, “good relationship with medical stuff”, “independence”, “maintaining hope and pleasure” of core domain were the important factor, and the scores were all over 4. However, the score of “life purpo completion” was below 4.
5 Nursing interns, medical stuff and general population considered that the score of “preparation for
death” which included “eing desired person”, “thanks for people around”, “saying out their own need” were over 4.
Conclusions
作文我最敬佩的人1 Nursing interns pay more attention on psychology and social need, but have few attention on physiology need. Medical college should pay attention to death education and guide students to think over the life thoroughly.
2 Medical stuff advocate natural life, not blindly prolong patient’s life meaninglessly.
