Lambert Heather C, McColl Mary Ann, Gilbert Julie, Wong Jiahui, Murray Gale, Shortt Samuel E D
Centre for Health Services and Policy Research, Queen's University, Abramsky Hall, 3rd floor, Kingston, Ontario.
Gerontologist. 2005 Oct;45(5):626-33. doi: 10.1093/geront/45.5.626.
The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care.
This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined.
Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations.
The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.
本研究旨在描述老年人在长期护理机构制定预立医疗指示时，影响其决策过程的因素。
本研究采用基于扎根理论的定性研究方法。采用目的抽样法进行招募，持续进行直至达到饱和状态。通过半结构化访谈形式对一家长期护理机构的9名居民进行了访谈。对访谈记录进行了开放式编码和轴心式编码，并确定了影响决策过程的因素。
老年人的决策主要基于从个人死亡和疾病经历中收集到的信息。他们从专业人士或媒体那里获得的信息很少。老年人在权衡信息时考虑的主要因素包括精神、情感和社会方面的因素。
决策过程中所考虑的因素更多地倾向于个人经历，而不是像预期的那样更多地依赖客观来源的信息。预立医疗指示的决策是一个高度个性化的过程。健康专业人员在协助临终决策时，应考虑这些影响因素来规划其方法，以便为这一人群中的个体提供的服务能够最好地满足他们的需求。
