儿童安宁疗护服务路径整合实践探讨——以复旦大学附属儿科医院为例  

Analysis on the Integrated Path of Pediatric Hospice Care:Based on Children's Hospital of Fudan University

作　　者：傅丽丽[1] 张灵慧[1] 汪庭娟 徐虹 陶毛毛 翟晓文 FU Li-li;ZHANG Ling-hui;WANG Ting-juan(Department of Medical Social Work,National Children's Medical Center/Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]国家儿童医学中心/复旦大学附属儿科医院社工部,上海201102 [2]国家儿童医学中心/复旦大学附属儿科医院肾脏科,上海201102 [3]华东理工大学社会与公共管理学院,上海200237 [4]国家儿童医学中心/复旦大学附属儿科医院血液肿瘤科,上海201102

出　　处：《医学与哲学》2021年第19期55-59,共5页Medicine and Philosophy

基　　金：2020年复旦大学附属儿科医院多学科诊疗(MDT)项目(MDT20006)。

摘　　要：基于文献法及20余例医务社工参与的儿童安宁疗护个案经验,建构出在三甲儿童专科医院内开展儿童安宁疗护的整合路径,分为安宁疗护服务启动、医务社工专业评估、安宁疗护场所选择及个性化关怀服务提供、安宁疗护服务终止。并分析影响实践的关键要素为多学科团队的搭建、家属对临终事实的接纳度、患儿家庭临终场所选择的意愿表达、家庭的照顾能力、社区医疗资源的可及性。最后结合文化语境和现状就儿童安宁疗护实践提出总结与建议。儿童安宁疗护服务路径整合实践提高了临终患儿的生命质量,也体现了以患儿家庭为本的人文关怀。Based on the literature review and medical social workers'experience of more than 20 pediatric hospice care cases,an integrated path to carry out pediatric hospice care in Third-Grade A children's hospital is constructed,which includes the initiation of hospice service,the professional evaluation of medical social workers,the choice of hospice place,the offer of personalized care service,and the termination of hospice service.Key elements that influence the practice are the construction of multidisciplinary team,the acceptance of family members to deathbed facts,the expression of deathbed place choices from the family,the competence of family care,and the accessibility of community medical resources.In the end,the paper puts forward implementation suggestions based on cultural context and reality.Integrated path of pediatric hospice care service improves the life quality of dying children and reflects patient-centered humanistic care.

关 键 词：三甲儿童专科医院 儿童安宁疗护 整合服务路径 医务社工 

分 类 号：R-05[医药卫生]