基于SPIKES沟通模式的病情告知在安宁疗护中的应用研究  

Application Research on Disease Informing based on SPIKES Communication Mode in Hospice Care

作　　者：诸海燕[1] 章婷婷 赵建国[1] 孙彩萍[1] 罗慧群[1] 顾佳欢 ZHU Hai-yan;ZHANG Ting-ting;ZHAO Jian-guo;SUN Cai-ping;LUO Hui-qun;GU Jia-huan(Shaoxing People's Hospital)

机构地区：[1]绍兴市人民医院

出　　处：《医院管理论坛》2021年第8期56-59,共4页Hospital Management Forum

基　　金：浙江省科技厅软科学研究项目:编号:2020C35072。

摘　　要：目的探讨基于SPIKES沟通模式的病情告知在安宁疗护工作中对患者正性、负性情绪及死亡态度的影响。方法选取某三级甲等综合医院2019年2月-12月收治住院的肿瘤临终患者49例为对照组,2020年1月-2020年11月收治住院的肿瘤临终患者46例为观察组。对照组患者予以常规的病情告知,观察组采用基于SPIKES沟通模式的病情告知。比较两组患者的正性、负性情绪及死亡态度。结果实行病情告知措施前两组患者的正性、负性情绪及死亡态度评分比较差异无统计学意义(p>0.05);实行病情告知后观察组患者负性情绪评分明显低于对照组(p<0.05),观察组患者在自然接受、趋近接受2个维度评分高于对照组,死亡恐惧及死亡逃避2个维度评分低于对照组,且差异有统计学意义(p<0.05)。结论基于SPIKES沟通模式的病情告知,可以缓解临终患者的负性情绪,降低其对死亡的恐惧、能自然接纳死亡,对安宁疗护工作的顺利开展起到积极作用。Objective To explore the impact of disease informing based on SPIKES communication mode on patients'positive and negative emotions and attitudes towards death in the hospice care.Methods A total of 49 end-of-life cancer patients admitted to a grade-A tertiary general hospital from February to December 2019 were selected as the control group,and 46 end-of-life cancer patients admitted from January 2020 to November 2020 were selected as the observation group.The patients in the control group were given regular disease informing,and the observation group was informed based on the SPIKES communication mode.The positive and negative emotions and attitudes to death of the two groups of patients were compared.Results There was no significant difference in the positive and negative emotions and death attitude scores between the two groups of patients before the implementation of the disease informing measures(p>0.05).After the implementation of the disease informing,the negative emotion scores of the observation group were significantly lower than those of the control group(p<0.05).The observation group had higher scores on the two dimensions of natural acceptance and approaching acceptance and the scores of death fear and death avoidance were lower than those of the control group.The difference was statistically significant(p<0.05).Conclusion The disease informing based on SPIKES communication mode can relieve the negative emotions of end-of-life patients,reduce their fear of death,help them accept death naturally,and play a positive role in the smooth development of hospice care.

关 键 词：SPIKES沟通模式 病情告知 安宁疗护 临终患者 正性负性情绪 死亡态度 

分 类 号：R197.3[医药卫生—卫生事业管理]