Sahlberg-Blom E, Ternestedt B M, Johansson J E
Department of Caring Sciences, Orebro University, S-701 82 Orebro, Sweden.
Nurs Ethics. 2000 Jul;7(4):296-313. doi: 10.1177/096973300000700404.
The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors' manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients' participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted differed in the respective variations; this seemed either to promote or to impede the patients' opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient's personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process.
本研究的目的是描述一组重症患者在生命末期护理计划决策中患者参与的差异，以及不同行为主体的行为方式如何促进或阻碍患者参与。对患者家属进行了37次定性研究访谈。患者在决策中的参与可分为四种类型：自主决定、共同决定、委托他人决定和不参与。在各自的类型中，患者、家属和护理人员的行为方式有所不同；这似乎要么促进要么阻碍了患者参与决策的机会。参与的可能性似乎取决于具体情况，并受到许多因素的影响，如临终患者的个性、社会网络、不同形式护理的可获得性、文化价值观，以及不同形式护理的护士和其他护理人员在决策过程中能够并愿意支持患者和家属意愿的程度。
