Agren Bolmsjö Ingrid, Nilstun Tore, Löfmark Rurik
Malmö University, School oF Health and Society, Malmö, Sweden.
Am J Hosp Palliat Care. 2007 Oct-Nov;24(5):366-70. doi: 10.1177/1049909107300213. Epub 2007 Jun 29.
Important issues in the transition from curative treatment to palliative care are agreement, timing, and decision making. A survey of 309 nurses and 415 physicians in Sweden showed that 61% of the nurses and 83% of the physicians thought agreement was current practice. None said that the decisions were made too early, but 19% of the nurses and 14% of the physicians thought that they often were made too late. Very few respondents stated that such decisions are changed, 0% and 1%, respectively. More than half of the informants made detailed comments on such transitions indicating that awareness and flexibility are desirable to make well-informed decisions. Three themes that emerged from the analysis concerning the decision to stop curative treatment and focus on palliative care were that the staff members should (if possible) make such decisions in agreement and should sometimes make the decisions earlier and that well-based reasons are required to make changes.
从根治性治疗过渡到姑息治疗的重要问题包括达成共识、确定时机和进行决策。对瑞典309名护士和415名医生的一项调查显示，61%的护士和83%的医生认为达成共识是当前的做法。没有人表示决策做出得太早，但19%的护士和14%的医生认为决策往往做出得太晚。很少有受访者表示此类决策会被更改，分别为0%和1%。超过一半的受访者对这种过渡发表了详细评论，表明做出明智的决策需要有认识和灵活性。关于停止根治性治疗并专注于姑息治疗的决策分析中出现的三个主题是，工作人员应（如果可能）在达成共识的情况下做出此类决策，有时应更早做出决策，并且做出改变需要有充分的理由。
