Lang F R, Wagner G G
Institut für Psychogerontologie, Universität Erlangen-Nürnberg, Erlangen.
Dtsch Med Wochenschr. 2007 Nov;132(48):2558-62. doi: 10.1055/s-2007-993097.
There is few data about how many people in Germany have deposited a living will or intend to do so. Most studies report distributions among patients, medical doctors or clinical personal. It is unclear, which pre-clinical conditions endorse the distribution of living wills. We were interested in which social contexts contribute to refusal of depositing a living will.
In two representative surveys with 400 and with 1023 adults, who were between 16 and 92 years old. Within both two multiple-purpose surveys it was assessed whether a living will was available, and if not, whether respondents planned or objected to do so.
About 10 percent of adults in Germany had deposited a living will pre-clinically. About fifty percent object to depositing a living will. Logistic regression analyses revealed that the distribution and acceptance of living will deposition depends on chronological age and personal experience with death and dying, even after statistically controlling for effects of socio-economic variables (education, income, household size). Adults are more likely to object to depositing a living will, if they are below 50 years old, do not eat healthy food, do no sports, have low income, and have not experienced death of a relative or acquaintance during the past year.
Acceptance of living will deposition depends in the pre-clinical phase of life on subjective experience related to medical end-of-life treatment. If people are confronted with death and dying in their social world, they will be more willing to consider their personal preference of end-of-life treatment.
关于德国有多少人已立下生前预嘱或打算立下生前预嘱的数据很少。大多数研究报告的是患者、医生或临床人员中的分布情况。尚不清楚哪些临床前状况会促使生前预嘱的分布。我们感兴趣的是哪些社会背景导致人们拒绝立下生前预嘱。
对400名和1023名年龄在16至92岁之间的成年人进行了两项代表性调查。在这两项多用途调查中,评估了是否有生前预嘱,若没有,受访者是否计划立下或反对立下生前预嘱。
德国约10%的成年人在临床前已立下生前预嘱。约50%的人反对立下生前预嘱。逻辑回归分析显示,即使在对社会经济变量(教育程度、收入、家庭规模)的影响进行统计控制之后,生前预嘱的分布和接受情况仍取决于实际年龄以及与死亡和濒死相关的个人经历。如果成年人年龄在50岁以下、不吃健康食品、不运动、收入低且在过去一年中没有经历过亲属或熟人的死亡,那么他们更有可能反对立下生前预嘱。
在生命的临床前阶段,生前预嘱的接受情况取决于与医疗临终治疗相关的主观体验。如果人们在其社会圈子中面临死亡和濒死,他们会更愿意考虑自己对临终治疗的个人偏好。