On hospice care in patients with advanced liver cancer in the importance of

[Abstract] hospice care with the medical model of change and the development of nursing science produced a new medical discipline, in order to improve the quality of life of dying patients for the purpose for dying patients with mental, physical and overall social support and care , so that in the last moments of life, enjoy the human warmth and love and comfort, calm, painless, dignified final journey through life, and provide psychological support for patients and their families. hepatocellular carcinoma is the world's highest mortality malignant tumor, according to incomplete statistics, China accounted for male liver cancer incidence and mortality of second Early symptoms of liver cancer is not obvious, when most patients already in the late treatment, so be patient with advanced liver cancer Hospice of the main target. For patients with advanced liver cancer, the implementation of good hospice care intervention, such patients can reduce the physical and psychological suffering on the fear, to maximize the quality of life, the nurse-patient relationship is more harmonious, harmonious.

[Keywords] hospice, advanced liver cancer, care, significant

1 Clinical data
August 2009 April 2011, our department were treated in the clinical diagnosis of 51 patients with advanced primary liver cancer, including 39 males and 12 females, aged 35-71 years, mean age 49.6 years, all patients showed varying degrees of loss of appetite, weight loss, fatigue, jaundice, ascites, lower extremity edema, liver pain, are losing the chance of operation, were given liver, immune, nutritional support and pain and other symptomatic treatment and hospice care measures.

2 hospice care
2.1 primary care: to provide patients with fresh air, sunny, warm, clean hospital environment, put some flowers in the wards, green, and equipped with cable television, in order to add vitality of life, joy of life, so that patients feel comfortable, reduce the fear of death, while spiritual solace to the families, reduce the loss of loved ones by giving them grief.

2.2 Psychological care: death is part of life, and no one can escape a process treatment when the patient was told to lose the opportunity of the moment, except to bear physical pain, but also under enormous psychological pressure. American psychiatrist, Dr. Elizabeth 库布勒罗斯 (Dr.Elisabeth Kubler-Ross) will face the death of most patients with complex mental and behavioral divided into five typical stages, namely the period of denial, anger period, agreement period, depression period and the acceptance period [1], which requires care workers under the mental patients in which the different stages for different care.

2.2.1 open communication with patients, sequential enlighten patients to help them establish a correct conception of death, according to Chen Bao-hong [2] reported that about 80% of patients think they should be aware of the diagnosis. Health care according to patient's age, personality, education level, know the extent of the disease and acceptance of other, select the appropriate time and content of the conversation, inform the patient's condition, attitude and sincere, calm tone of voice, this time to ensure the privacy of the environment [3]. talk with patients When the natural relaxed posture, proper use of body language, causing the patient to avoid combat or adverse mental association.

2.2.2 sympathy for patients, comprehensive psychological support given to the nurse must be patient and careful observation of the patient's behavior, facial expressions, posture and other non-verbal behavior and known to express its meaning, to facilitate the discovery of a variety of patient needs and try to meet them.

2.2.3 Psychological support for families of patients: psychological care for family members of patients is an important part of hospice care, family members of patients regardless of disease, illness from the patient to death, not only to withstand the day and night to take care of the patient's physical torture, sometimes bear the patient's fault, blame, blame and other mental pressure. early to families of patients to disseminate scientific knowledge, step by step account of illness, when the patient's condition deteriorated, the nurse should be timely to talk and communicate with their families, so do good fully prepared.

Appropriate for family members in death education, guiding them to adjust their attitude at the same time, make some life care, to accompany the patient spent the final stage of life, so that family members of patients to get a little psychological comfort to the patient after the death of nurse bodies do dishes, such as brush, clothing, etc., so that the patient clean, leave peacefully. In addition, for some families of repressed emotion, to guide them at the right time, right way to vent their grief. Share on free download http://www.hi138.com 2.3 of pain in patients with advanced liver cancer care: pain is a common form of liver cancer patients with advanced symptoms, according to statistics, cancer pain in patients with advanced liver cancer incidence rate as high as 60 - 70%, and more for moderate to severe and very severe pain, unbearable pain often causes patients to lose courage and confidence to survive, and even suicide [4]. Kelly et al [5] studies have shown that 22% of the advanced cancer patients as quickly as possible to reduce the pain caused by the death of the physical and psychological suffering. suppression of pain in patients with advanced liver cancer is an important part of hospice care, according to the WHO recommended three-step method of relieving pain of cancer, accurate use of pain medication, on time volume, different routes of administration, to observe the response after treatment for severe abdominal pain should closely observe the situation and vital signs, guard against cancer and gastrointestinal bleeding and bleeding complications in the use of medication at the same time, listen to tell patients to understand the patient's psychological characteristics, pain to the patients and their families to explain the reasons and principles of medication to get rid of the disease from the spirit of fear. It is reported that advanced cancer patients with anxiety and fear of emotional pain were significant positive correlation, therefore, the use of drug treatment, this can also use some intervention techniques to minimize the pain to the patient's psychological and emotional burden and maximize quality of life [6]. Some experts believe that such method of 40% of patients [7].

3 Results
The group received care for 51 patients with advanced liver cancer patients, can readily accept their condition, comfortable, quiet, calm face of death, in a relaxed mood has completed the final journey of life.

4 Discussion
Hospice care a new medical discipline, as care workers, we have to establish a correct concept of care, hospice care to enhance awareness and strengthen the psychology, sociology and ethics, knowledge of learning, do their best for dying patients and their family services.

In short, hospice care for patients with advanced liver cancer intervention, can make patients dying within a limited time, comfortable, quiet, no pain, dignity, take the final journey of life, social development and reflect the progress of human civilization, is China's "people first" philosophy is the best interpretation.

References
[1] Kubler-Ross E. "Pain and suffering of the dying"-a lecture.With love and honesty [J]. Krankenpfl Soins Infirm, 1992,85 (6) :57-61.

[2] Chen Bao-hong in the late stage the patient's psychological needs and care [J]. Journal of nursing, 1996,31 (1:33.

[3] Wang Yixin, Xu Yan, Shen Jie. Prognostic evaluation of patients with end-stage cancer-related Research [J]. nursing Research, 2009,23 (3A) :576-578.

[4] Kingdom Princess. Hospice patients with advanced hepatocellular carcinoma [J]. General care, 2009,7 (7:1893-1896.

[5] Kelly B, Burnett P, Pelusi D. Terminally ill cancer patients' wish to hasten death [J]. Palliative Med, 2002,16 (4) :339-345.

[6] Yi Shu-zhen, Zhang Li, Shao Yun.'s Understanding of the standardized treatment of cancer pain. Chinese Clinical Rehabilitation, 2003,7 (11:1706.

[7] Wong Choi Yun, Chen Feng parrot. Hospice patients with advanced cancer care [J]. Fujian Journal of Medicine, 2002,24 (6:18 Links to free download http://www.hi138.com