Fisher Kathleen M, Green Michael J, Orkin Fredrick K, Chinchilli Vernon M
College of Nursing and Health Professions, Drexel University, Mail Stop 501, 245 North 15th Street, Philadelphia, PA19102-1101, USA.
J Intellect Dev Disabil. 2009 Sep;34(3):258-65. doi: 10.1080/13668250903083332.
Little is known about surrogate healthcare decision-making for individuals with intellectual disability (ID). This study examined healthcare decision-making by residential-agency directors to learn their process and the extent to which the individual is included.
Content analysis of qualitative data from a mailed survey of residential-agency directors in a large US northeastern state.
Narrative comments of 102 directors (65% of respondents) are reported. Three themes emerged: (a) Identifying someone else's "best interest" is challenging; (b) Perceptions of the healthcare community, especially related to quality of life, can influence care provided; and (c) Surrogate decision-making is a team effort.
With knowledge of how decisions are made, the healthcare community can better interact with the complex array of service agencies and persons who determine care for this vulnerable population.
对于智障人士的替代医疗决策，人们了解甚少。本研究调查了寄宿机构负责人的医疗决策情况，以了解他们的决策过程以及个人参与的程度。
对美国东北部一个大州的寄宿机构负责人邮寄调查的定性数据进行内容分析。
报告了102位负责人（占受访者的65%）的叙述性评论。出现了三个主题：（a）确定他人的“最大利益”具有挑战性；（b）对医疗界的看法，尤其是与生活质量相关的看法，会影响所提供的护理；（c）替代决策是团队的努力。
了解决策是如何做出的后，医疗界可以更好地与决定为这一弱势群体提供护理的一系列复杂服务机构和人员进行互动。
