透析患者对基于家庭的预先护理计划的偏好。
Dialysis patients' preferences for family-based advance care planning.
作者信息
Hines S C, Glover J J, Holley J L, Babrow A S, Badzek L A, Moss A H
机构信息
West Virginia University, Morgantown 26506-9022, USA.
出版信息
Ann Intern Med. 1999 May 18;130(10):825-8. doi: 10.7326/0003-4819-130-10-199905180-00016.
BACKGROUND
Most patients do not participate in advance care planning with physicians.
OBJECTIVE
To examine patients' preferences for involving their physicians and families in advance care planning.
DESIGN
Face-to-face interviews with randomly selected patients.
SETTING
Community-based dialysis units in one rural and one urban region.
PARTICIPANTS
400 hemodialysis patients.
MEASUREMENTS
Questions about whom patients involve in advance care planning, whom patients would like to include in this planning, and patients' reactions to state legislation on surrogate decision makers in end-of-life care.
RESULTS
Patients more frequently discussed preferences for end-of-life care with family members than with physicians (50% compared with 6%; P < 0.001). More patients wanted to include family members in future discussions of advance care planning than wanted to include physicians (91% compared with 36%; P < 0.001). Patients were most comfortable with legislation that granted their family end-of-life decision-making authority in the event of their own incapacity (P < 0.001).
CONCLUSION
Most patients want to include their families more than their physicians in advance care planning.
背景
大多数患者未与医生进行预先护理计划。
目的
研究患者对于让医生和家人参与预先护理计划的偏好。
设计
对随机选取的患者进行面对面访谈。
地点
一个农村地区和一个城市地区的社区透析单位。
参与者
400名血液透析患者。
测量
关于患者在预先护理计划中会让谁参与、希望谁参与以及患者对临终护理中关于替代决策者的州立法的反应的问题。
结果
患者与家庭成员讨论临终护理偏好的频率高于与医生讨论的频率（分别为50%和6%；P<0.001）。希望在未来预先护理计划讨论中纳入家庭成员的患者多于希望纳入医生的患者（分别为91%和36%；P<0.001）。患者对赋予其家人在其无行为能力时临终决策权力的立法最为满意（P<0.001）。
结论
大多数患者在预先护理计划中希望家人参与的程度超过医生。
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