Kim Su Hyun, Kjervik Diane
7460 Carrington Hall, School of Nursing, The University of North Carolina, Chapel Hill, NC 27599-7460, USA.
Nurs Ethics. 2005 Sep;12(5):493-506. doi: 10.1191/0969733005ne817oa.
The aim of this study was to investigate factors associated with seriously ill patients' preferences for their family and physicians making resuscitation decisions on their behalf. Using SUPPORT II data, the study revealed that, among 362 seriously ill patients who were experiencing pain, 277 (77%) answered that they would want their family and physicians to make resuscitation decisions for them instead of their own wishes being followed if they were to lose decision-making capacity. Even after controlling for other variables, patients who preferred the option of undergoing cardiopulmonary resuscitation (CPR) in the future were twice as likely, and those who had had ventilator treatment were four-fifths less likely, to rely on their family and physicians than those who did not want CPR (odds ratio (OR) = 2.28; 95% confidence interval (CI) 1.18-4.38) or those who had not received ventilator treatment (OR = 0.23; 95% CI 0.06-0.90). Psychological variables (anxiety, quality of life, and depression), symptomatic variables (severity of pain and activities of daily living) and the existence of surrogates were not significantly associated with patients' preferences for having their family and physicians make resuscitation decisions for them. Age was not a significant factor for predicting the decision-making role after controlling for other variables.
本研究的目的是调查与重症患者偏好其家属和医生代表他们做出复苏决策相关的因素。利用SUPPORT II数据，该研究显示，在362名正在经历疼痛的重症患者中，277名（77%）回答说，如果他们失去决策能力，他们希望家属和医生为他们做出复苏决策，而不是遵循他们自己的意愿。即使在控制了其他变量之后，与那些不希望进行心肺复苏（CPR）的患者（比值比（OR）=2.28；95%置信区间（CI）1.18 - 4.38）或未接受过呼吸机治疗的患者（OR = 0.23；95% CI 0.06 - 0.90）相比，未来倾向于接受心肺复苏的患者依赖家属和医生的可能性是前者的两倍，而接受过呼吸机治疗的患者依赖家属和医生的可能性要低五分之四。心理变量（焦虑、生活质量和抑郁）、症状变量（疼痛严重程度和日常生活活动能力）以及代理人的存在与患者偏好家属和医生为他们做出复苏决策没有显著关联。在控制了其他变量之后，年龄不是预测决策角色的显著因素。
