Sittisombut Sudarat, Inthong Suwit
Department of Surgical Nursing, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
Int J Nurs Pract. 2009 Apr;15(2):119-25. doi: 10.1111/j.1440-172X.2009.01730.x.
Surrogate decision-maker for end-of-life care is indicated at certain points during care for patients with terminal illnesses. This study aimed at identifying person(s) to whom northern Thai patients with terminal illnesses wished to transfer their decisions on end-of-life care and for cardiopulmonary resuscitation. From interviews with 152 eligible subjects, 57.2% had a high regard for their physicians' authority in making decisions on end-of-life care, 28.3% transferred their decisions to relative(s) and only 14.5% opted for shared decision-making among relative(s) and physicians. In the provision of cardiopulmonary resuscitation, 44.1% of subjects expressed a desire for family to make decisions together with physicians, 33.6% gave directives to the family alone and only 22.4% transferred their decisions to physicians. The differences that were observed in patients' preferences between the two situations indicate that patients should be assessed individually and adequate information for decision-making should be provided.
在对绝症患者的护理过程中的某些阶段，需要指定临终护理的替代决策者。本研究旨在确定泰国北部绝症患者希望将其临终护理和心肺复苏决策转交给谁。通过对152名符合条件的受试者进行访谈，57.2%的人高度认可医生在临终护理决策方面的权威，28.3%的人将决策权转交给亲属，只有14.5%的人选择在亲属和医生之间进行共同决策。在心肺复苏方面，44.1%的受试者表示希望家属与医生共同做出决策，33.6%的人仅向家属发出指示，只有22.4%的人将决策权转交给医生。在这两种情况下观察到的患者偏好差异表明，应对患者进行个体评估，并应提供足够的决策信息。
