Duffy Sonia A, Ronis David, Fowler Karen, Schim Stephanie Myers, Jackson Frances C
Department of Veterans Affairs, VA HSR&D Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan 48113-0170, USA.
J Palliat Med. 2006 Oct;9(5):1099-105. doi: 10.1089/jpm.2006.9.1099.
Investigators conducting focus groups on end-of-life preferences noted that veterans voiced opinions that strongly differed from those of nonveterans.
The objective of this study was to further explore differences between veterans' and nonveterans' end-of-life preferences.
Ten focus groups and a pilot survey were conducted.
The focus groups consisted of Arab Muslims, Arab Christians, Hispanics, blacks, and whites stratified by gender (n = 73). Fifteen male veterans were included across all five racial groups.
A moderator discussion guide was used to lead the focus groups and a pilot survey asked about demographic information and end-of-life preferences.
Veterans were more likely to be married (p < 0.05) and less connected to their cultural group (p < 0.05) than nonveterans. The focus group results indicated that veterans in this study were more likely to oppose the use of heroic measures compared to nonveterans. More so than nonveterans, veterans felt that their doctors should be frank and open (p < 0.05) were strongly in favor of do-not-resuscitate (DNR) orders (p < 0.10), yet were less likely to have a proxy (p < 0.10) or durable power of attorney p < 0.01). Comparing end-of-life preferences, veterans felt less strongly than nonveterans about remembering personal accomplishments (p < 0.05), being listened to (p < 0.05), being with friends (p < 0.01), or being comfortable with their nurse (p < 0.05), but did want to be around their pets at the end of life p < 0.10).
The Department of Veterans Affairs is in a unique position to improve endof- life care for veterans. Providing end-of-life care that is congruent with the veteran's wishes can improve satisfaction and increase cost effectiveness by eliminating unacceptable services.
进行临终偏好焦点小组研究的调查人员指出，退伍军人表达的意见与非退伍军人的意见有很大差异。
本研究的目的是进一步探讨退伍军人和非退伍军人临终偏好的差异。
进行了10个焦点小组和一项试点调查。
焦点小组由按性别分层的阿拉伯穆斯林、阿拉伯基督徒、西班牙裔、黑人和白人组成（n = 73）。所有五个种族群体中共有15名男性退伍军人。
使用主持人讨论指南来引导焦点小组，试点调查询问了人口统计信息和临终偏好。
与非退伍军人相比，退伍军人结婚的可能性更大（p < 0.05），与文化群体的联系更少（p < 0.05）。焦点小组的结果表明，与非退伍军人相比，本研究中的退伍军人更有可能反对采取英勇措施。与非退伍军人相比，退伍军人更觉得他们的医生应该坦诚开放（p < 0.05），强烈支持不要复苏（DNR）医嘱（p < 0.10），但拥有代理人（p < 0.10）或持久授权书的可能性较小（p < 0.01）。比较临终偏好，退伍军人在铭记个人成就（p < 0.05）、被倾听（p < 0.05）、与朋友在一起（p < 0.01）或与护士相处融洽（p < 0.05）方面的感受不如非退伍军人强烈，但确实希望在生命结束时身边有宠物（p < 0.10）。
退伍军人事务部在改善退伍军人的临终护理方面具有独特的地位。提供符合退伍军人意愿的临终护理可以通过消除不可接受的服务来提高满意度并提高成本效益。
