Psychosocial care provided by nurses in palliative care

Palijativna skrb se može definirati kao pristup pomoću kojeg se bolesniku koji boluje od teške neizlječive bolesti može pomoći poboljšati kvaliteta života od dijagnoze pa sve do smrti. Djeluje multiprofesionalnim i interdisciplinarnim timskim načinom rada na tri razine kao palijativni pristup, opća palijativne skrb i specijalistička palijativna skrb te se kao četvrta razina spominju centri izvrsnosti. Zdravstvena njega bolesnika s potrebom palijativne skrbi je specifična zbog specifičnosti raznih malignih oboljenja. Rad po procesu zdravstvene njege s individualnim, holističkim pristupom je temelj za dobru palijativnu skrb. Koordiniranje, rukovođenje timom, utvrđivanje potreba, planiranje, provođenje i evaluacija ciljeva zdravstvene njege kompetencije su kojima se vodi medicinska sestra/tehničar u palijativnoj skrbi. SPIKES protokol koji se primjenjuje prilikom priopćavanja loših vijesti služi kako bi se prikupile informacije, prenijela medicinska saznanja, pružila podrška bolesniku, pridobilo njegovo povjerenje za daljnju suradnju i na kraju izradila strategija za buduće intervencije. Medicinska sestra/tehničar zajedno s bolesnikom i njegovom obitelji prolaze kroz sve faze koje su potrebne da bi bolesnik prihvatio svoju bolest i da bi se mogao pripremiti za dostojanstvenu smrt. Psihološka podrška palijativnom bolesniku se temelji na fizičkoj pomoći i dobroj komunikaciji kojom se u ovoj skrbi postižu zacrtani ciljevi, a prema izrađenim planovima, provodi se palijativna skrb s kontinuiranom evaluacijom. Važna zadaća medicinske sestre je da sudjeluje u skrbi za bolesnika na način da mu pomaže u prepoznavanju, razvijanju i primjeni strategija za suočavanje s neizlječivom bolešću. U skrb za bolesnika s potrebom za palijativnom skrbi te njegovom obitelji palijativna skrb uključuje duhovnu dimenziju skrbi te je medicinska sestra nakon smrti podrška cijeloj obitelji u procesu žalovanja.Palliative care can be defined as a specific approach that can help a patient suffering from severe incurable diseases to improve their quality of life from diagnosis to death. It operates in a multi-professional and interdisciplinary team way of working on three levels as a palliative approach, general palliative care and specialist palliative care, and centers of excellence are mentioned as the fourth level. The health care of a palliative patient is specific due to the specificity of various malignant diseases. Working through a health care process with an individual, holistic approach is the foundation for good palliative care. Coordination, team management, needs identification, planning, implementation and evaluation of health care goals are the competencies of a palliative care nurse / technician. The SPIKES protocol used to communicate bad news serves to gather information, impart medical knowledge, provide support to the patient, gain his trust for further cooperation, and ultimately develop a strategy for future interventions. The nurse / technician, together with the patient and his family, goes through all the stages necessary for the patient to accept his illness and to be able to prepare for a dignified death. Psychological support for the palliative patient is based on physical assistance and good communication, which achieves the set goals in this care. According to the developed plans, palliative care is carried out with continuous evaluation. The nurse / technician, together with the patient and his family, goes through all the stages necessary for the patient to accept his illness and to be able to prepare for a dignified death. Psychological assistance to the patient in accepting the disease, and during treatment, and assistance to the family after the loss is the task of every nurse / technician. The nurse / technician has a significant role to play in the mourning phase. Quality communication with the family both during the patient's illness and after his death should be continuous