社区护理病房中长期慢性病患者的照料服务机制——基于质性研究的方法

现有社区护理病房照料服务存在不能充分满足患者的深层需求、生活质量不佳的问题。访谈材料显示出由于照料者缺乏对“善终”概念的认知，患者、家属以及医护人员的三方关系中，患者处于权力的弱势地位，主体之间在讨论死亡相关问题上存在严重的脱节。患者的意愿从表达、传递、实施等环节中都存在阻碍，患者“善终”的需求无法实现。“以患者为中心”的照料理念应在现有照料服务中加以推广，通过提升社区照料质量来满足医学关系、家庭关系和患者自身利益的既定政策目标。

Care Service Mechanism for Long-term Chronic Patients in Community Nursing Wards: A Qualitative Research Approach

Existing community nursing care services fail to fully meet patients' deep needs, leading to poor quality of life. Interviews reveal a lack of understanding about the concept of "good death" among caregivers. Amid the triadic relationship of patients, family members, and medical staff, patients are marginalized, leading to a significant disconnect when discussing death-related issues. Obstacles are present in every stage of expressing, transmitting, and implementing patients' wishes, hindering the realization of a "good death". The patient-centered care philosophy should be promoted in current care services, enhancing community care quality to achieve medical, familial, and individual patient interests as per-established policy goals.