关于长春市老年临终关怀融入社区的困境与对策研究

蔺甫 李欣 张敏

[摘要]目的 了解長春市广大社区医务人员及居民对老年患者临终关怀的认知情况，并探析其发展困境，为社区医院临床工作开展临终关怀项目提供有力的依据。方法 采用便利抽样的方法于2018年10月～2019年4月在长春市4家社区医院及2家社区抽取207名人员（医务人员53名，居民154名）进行调查。结果 博士学历医务人员的合格率与硕士比较，差异无统计学意义（P>0.05）;硕士与博士学历医务人员的合格率均高于中专、大专、本科，差异有统计学意义（P<0.05）;本科医务人员的合格率高于中专、大专，差异有统计学意义（P<0.05）;大专医务人员的合格率高于中专，差异有统计学意义（P<0.05）。不同职位医务人员对临终关怀认知的合格率比较，差异无统计学意义（P>0.05）。150名社区居民临终关怀的认知总得分为（71.43±13.94）分。结论 长春市各大社区医务人员对临终关怀的认知水平层次不齐，整体水平偏低，社区居民对临终关怀服务了解不足，没有形成积极认识，相关机构应就此问题重点加强对两者的教育力度，提升其对临终关怀的认知能力。

[关键词]医务人员;社区居民;临终关怀;认知情况

[中图分类号] R743.2          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0176-04

[Abstract] Objective To understand the cognition of community medical personnel and residents in Changchun on hospice care for elderly patients， and explore its development dilemma， so as to provide a strong basis for the clinical work of community hospitals to carry out hospice care projects. Methods A total of 207 people （53 medical staff and 154 residents） were surveyed from 4 community hospitals and 2 communities in Changchun from October 2018 to April 2019 by convenient sampling method. Results The qualified rate of medical personnel with doctor′s degree was not significantly different from that of master′s degree （P>0.05）. The qualified rate of medical personnel with master′s degree and doctor′s degree was higher than that of technical secondary school， junior college and undergraduate， and the differences were statistically significant （P<0.05）. The qualified rate of undergraduate medical personnel was higher than that of technical secondary school and junior college， and the differences were statistically significant （P<0.05）. The qualified rate of college medical personnel was higher than that of technical secondary school， and the difference was statistically significant （P<0.05）. There was no significant difference in the qualified rate of the cognition of hospice care among the medical staff of different positions （P>0.05）. The cognition total score of the 150 community residents on hospice care was （71.43±13.94） points. Conclusion In Changchun， the level of cognition about hospice care of medical staff is not uniform， the overall level is low， the community residents do not know enough about hospice care services， and there is no positive understanding. The relevant organizations should focus on strengthening the education of the two， and improve their cognitive ability of hospice care. 

[Key words] Medical personnel; Community residents; Hospice care; Cognitive situation

临终关怀是指为生存时间极为有限的患者提供综合性医疗服务，以一定程度上减轻患者的痛苦，提升患者的生存质量，使其有尊严地离开人世[1]。临终关怀服务对象的范畴是指在医学上已被确诊为无法治愈，且存活期可能仅有6个月左右的患者和由于身体机能衰退几乎要走到生命终点的老年人[2]。……