刘瑾　朱娓　张翠萍

[摘要] 目的 調查肿瘤医院护士姑息护理知识掌握现状，并对影响因素进行分析。 方法 采用便利抽样法选择2017年6～8月新疆医科大学附属肿瘤医院注册护士280名作为研究对象，应用姑息护理知识问卷（PCQN）对护士姑息护理知识掌握情况进行调查，并分析其影响因素。 结果 PCQN问卷3个维度中，疼痛症状控制得分最高，其次为姑息护理哲理和原则、心理精神和社会支持。不同组别年龄、职称、学历和工作年限护士姑息护理知识得分比较，差异均有高度统计学意义（P < 0.01）；接受姑息护理知识培训的护士姑息护理知识得分明显高于未接受培训护士，差异有高度统计学意义（P < 0.01）。姑息护理知识得分3个维度影响因素的多元逐步分析显示，影响疼痛控制的因素为学历和工作年限（F = 66.494，P < 0.01，R2 = 0.324）；影响姑息护理哲理与原则的因素为学历、职称和工作年限（F = 490.955，P < 0.01，R2 = 0.842）；心理精神和社会支持的影响因素为年龄和工作年限（F = 114.093，P < 0.01，R2 = 0.452）。 结论 肿瘤专科医院护士姑息护理知识得分较低，说明护士对姑息护理知识掌握不足，需要加强死亡及姑息护理知识教育，从而为提高护士姑息护理知识培训提供依据。

[关键词] 肿瘤；姑息护理；死亡教育；影响因素

[中图分类号] R473.73 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0129-04

Investigation and influencing factors of palliative care knowledge among nurses in cancer hospital

LIU Jin1 ZHU Wei2 ZHANG Cuiping3

1.Integrated Department of Traditional and Western Medicine， Tumor Hospital Affiliated to Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830011， China； 2.Department of Breast and Lymphoma， Tumor Hospital Affiliated to Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830011， China； 3.Nursing Department， Tumor Hospital Affiliated to Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830011， China

[Abstract] Objective To investigate the current status of palliative care knowledge in cancer hospital nurses and to analyze the influencing factors. Methods From June to August 2017， 280 registered nurses in Tumor Hospital Affiliated to Xinjiang Medical University were selected as the research objects by convenience sampling method. The palliative care quiz for nursing （PCQN） was used to investigate the status of palliative care knowledge in nursing staff and its influencing factors were analyzed. Results Among the 3 dimensions of PCQN， pain control had the highest score， then palliative care philosophy and principles， psychological and social support respectively. There were statistically significant differences among different ages， titles， education background and working years （P < 0.01）； the score of nurses trained in palliative care was significantly higher than that of untrained nurses， with statistically significant difference （P < 0.01）. The multiple stepwise analysis of the factors influencing the score of palliative care knowledge in 3 dimensions showed that the influencing factors of pain control were education and working years （F = 66.494， P < 0.01， R2 = 0.324）； influence factors of palliative care philosophy and principles were education， titles and working years （F = 490.955， P < 0.01， R2 = 0.842）； the influencing factors of psychological and social support were age and working years（F = 114.093， P < 0.01，R2 = 0.452）. Conclusion The score of palliative care knowledge in nurses of tumor hospital is low， indicating that nurses is lack of palliative care knowledge. It needs to strengthen the death and palliative care knowledge education， so as to provide the basis for improving palliative nursing knowledge training.

[Key words] Tumor； Palliative care； Death education； Influencing factors

随着老龄化社会的步入，恶性肿瘤及慢性疾病的增多，姑息护理作为提高患者及家属生活质量的重要措施已得到了全球关注[1]。姑息护理又称安宁护理，主要是通过预防、评估和控制疼痛，缓减身体的不适症状，同时处理患者及家属在心理、社会和心灵上的问题，来提升患者的终末生命质量，它符合人类对全程生命质量的客观要求，是社会文明高度发展的标志[2]。姑息护理的主要服务对象是癌症患者及其家属[3]。据卫生部第三次全国死因调查显示，恶性肿瘤死亡在我国城乡居民死亡原因中居于第二位，而在城市居民死亡原因中居首位[4]，因此，恶性肿瘤患者在确诊后的治疗过程中，对姑息护理的需求大大增加。而通过叶华丹等[5]对美澳两国本科姑息护理课程现状的分析发现，我国姑息护理的教学及发展存在较多的问题。……