Brown Margaret
Hawke Institute, University of South Australia.
Aust Fam Physician. 2002 Jan;31(1):60-2.
'Advance directives' are instructions given by an individual regarding future health care decisions should they become incapacitated.
To explore the issues for GPs when introducing advance directives to their patients as a basis for further research into this process.
Interviews with GPs before and after the introduction of advance directives to patients during a normal consultation. General practitioners, from two medical practices in South Australia, were asked to record demographic details, time taken, patient's reaction and information requested.
Five GPs introduced advance directives to 26 patients. The average age was 77 years. Six of the 26 patients completed an advance directive. The main issues identified when introducing advance directives were the time factor and difficulty in advising patients about the kinds of medical treatment they might want to record in advance.
General practitioners require time and information if they are to assist patients in the process of completing an advance directive. Further research and extensive public education are necessary to develop relevant strategies to encourage the use of advance directives if they are to be utilised to assist people to face death with some sense of control.
“预立医疗指示”是个人在丧失行为能力时就未来医疗决策给出的指示。
探讨全科医生在向患者介绍预立医疗指示时遇到的问题,以此作为对这一过程进行进一步研究的基础。
在正常诊疗过程中,在向患者介绍预立医疗指示之前和之后对全科医生进行访谈。要求来自南澳大利亚两家医疗诊所的全科医生记录人口统计学细节、花费的时间、患者的反应以及所需信息。
5名全科医生向26名患者介绍了预立医疗指示。患者平均年龄为77岁。26名患者中有6名完成了预立医疗指示。在介绍预立医疗指示时发现的主要问题是时间因素以及难以就患者可能希望预先记录的医疗治疗类型向其提供建议。
如果全科医生要协助患者完成预立医疗指示的过程,他们需要时间和信息。如果要利用预立医疗指示帮助人们在面对死亡时能有一定的掌控感,就需要进一步研究和广泛的公众教育来制定相关策略以鼓励使用预立医疗指示。