Kaldjian Lauris C, Shinkunas Laura A, Bern-Klug Mercedes, Schultz Susan K
Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.
Am J Hosp Palliat Care. 2010 Sep;27(6):387-97. doi: 10.1177/1049909109358660. Epub 2010 Feb 18.
Surrogate decision makers for persons with advanced dementia play a key role in making decisions about medical treatments for their loved ones. We conducted in-depth interviews of 20 surrogates to examine their goals of care preferences and beliefs about personhood. All surrogates believed the goal of comfort was important, and 30.0% believed that curing physical problems was important. Significant proportions of surrogates acknowledged dementia-related changes in patients' ability to reason, communicate, and relate to others. Qualitative findings demonstrated diverse beliefs regarding the impact of dementia on factors related to personhood, for example, dignity, respect from others, and having a life worth living. In conclusion, the surrogates we interviewed expressed diverse preferences regarding goals of care and diverse assessments about the impact of dementia on personhood.
晚期痴呆症患者的替代决策者在为其亲人做出医疗治疗决策方面发挥着关键作用。我们对20名替代决策者进行了深入访谈，以研究他们的护理偏好目标以及对人格的看法。所有替代决策者都认为舒适的目标很重要，30.0%的人认为治愈身体问题很重要。相当比例的替代决策者承认患者在推理、沟通和与他人交往能力方面与痴呆症相关的变化。定性研究结果表明，对于痴呆症对与人格相关因素（如尊严、他人的尊重以及有价值的生活）的影响，存在不同的看法。总之，我们采访的替代决策者在护理目标方面表达了不同的偏好，对痴呆症对人格的影响也有不同的评估。
