应用Rodgers演化概念分析法界定安宁疗护需求及启示 [中文引用][英文引用]

目的  采用 Rodgers 演化概念分析法界定安宁疗护需求的核心属性、前因及后果，为终末期患者需求评估和本土化护理实践提供理论依据。方法  系统检索中国知网，万方，维普，中国生物医学文献数据库，PubMed，Web of Science 和Cochrane Library 数据库中建库至 2025 年 5 月发表的相关文献，最终纳入 42 篇中英文文献，依据 Rodgers 演化概念分析法进行分析。结果  安宁疗护需求是生命末期情境下形成的多维动态概念，其核心属性包括生理舒缓、心理情感支持、灵性安顿和社会关系维系；前因包括疾病不可逆性、资源可及性和文化背景；后果主要表现为终末期症状控制改善、心理社会与灵性痛苦缓解、医疗决策优化，以及需求未满足时的疼痛失控、关系遗憾和决策冲突等负面结果。结论  安宁疗护需求并非单一症状控制诉求，而是受疾病进展、服务资源和文化价值共同影响的综合性照护需求。护理实践应基于四维属性开展动态评估，强化文化敏感沟通和连续照护支持，以促进终末期患者舒适、尊严和生命质量的提升。

Objective To define the core attributes，antecedents and consequences for hospice care needs using Rodgers’ evolutionary concept analysis，and to provide a theoretical basis for needs assessment and localised nursing practice for patients at the end of life. Methods A systematic literature search was conducted on databases of CNKI，Wanfang Data，VIP Database，SinoMed， PubMed，Web of Science and Cochrane Library from the inception to May 2025. A total of 42 Chinese and English publications were included and analysed according to Rodgers’evolutionary concept analysis. Results The needs for hospice care were identified as a multidimensional and dynamic concept in the end-of-life context. The core attributes were identified：physical comfort，psychological and emotional support，spiritual settlement，and maintenance of social relationships. The antecedents included disease irreversibility， resource accessibility，and cultural background. The consequences included improved symptom control，alleviation of psychosocial and spiritual suffering，optimised medical decision-making，and negative outcomes when needs were unmet，such as uncontrolled pain，relational regret，and decision-making conflicts. Conclusion The needs for hospice care are not limited to symptom control，but a comprehensive care shaped by disease progression，service resources and cultural values. Nursing practice should conduct dynamic assessment based on the four attributes and strengthen culturally sensitive communication and continuous care support to improve comfort，dignity and quality of life among the patients at end of life.