Verelst S G R, Pasman H R W, Onwuteaka-Philipsen B D, Ribbe M W, van der Wal G
VU medisch Centrum, Afdeling Sociale Geneeskunde, EMGO-Instituut, Amsterdam.
Tijdschr Gerontol Geriatr. 2006 Apr;37(2):51-8.
The purpose of this study is to investigate how relatives of nursing home patients with dementia, for whom the decision whether to start or forgo artificial nutrition and hydration (ANH) was made, assess the decision-making process. Furthermore we evaluated the information given by the nursing home staff to the relatives and the care provided by them to the patient. The study was an observational study based on written questionnaires. Relatives of 99 nursing home patients with dementia filled in a questionnaire at the time of the decision-making and 6 weeks after the decision was made or 6 weeks after the patient had died. Almost all relatives assessed the 4 aspects of the decision-making process (number of consults, content of the consults, carefulness of the decision-making and there own part in the decision-making process) at both times as 'good' or 'satisfactory'. Furthermore it appeared that they judged the carefulness of the decision-making process significantly more often as 'good' when they also assessed the other three aspects as 'good'. Especially their own influence on the decision-making process appeared to play a part in this matter. Information about the possible consequences of starting ANH as well as about the condition of the patient were experienced sufficient by almost all relatives. This was also the case for the care offered to the patient. In general almost all relatives reported satisfaction with the decision and with the carefulness of the decision-making process. This satisfaction did not differ between the moment of the decision and afterwards. For this it did not make any difference whether the patient had or had not died.
本研究的目的是调查养老院中患有痴呆症患者的亲属,在做出是否开始或放弃人工营养和水分补充(ANH)的决定后,如何评估决策过程。此外,我们还评估了养老院工作人员向亲属提供的信息以及他们为患者提供的护理。该研究是一项基于书面问卷的观察性研究。99名养老院痴呆症患者的亲属在决策时以及决策后6周或患者死亡后6周填写了问卷。几乎所有亲属在两个时间点都将决策过程的四个方面(咨询次数、咨询内容、决策的谨慎程度以及他们自己在决策过程中的参与度)评为“好”或“满意”。此外,当他们也将其他三个方面评为“好”时,他们更常将决策过程的谨慎程度评为“好”。特别是他们自己对决策过程的影响似乎在这件事情中起到了作用。几乎所有亲属都充分了解了开始ANH的可能后果以及患者的病情。患者所接受的护理情况也是如此。总体而言,几乎所有亲属都对决策和决策过程的谨慎程度表示满意。这种满意度在决策时和之后没有差异。为此,患者是否死亡并无任何影响。