Ghent University, Heymans Institute of Pharmacology, Gent, Belgium.
J Intellect Disabil Res. 2010 Dec;54(12):1067-77. doi: 10.1111/j.1365-2788.2010.01335.x. Epub 2010 Nov 11.
This article aims to describe the presence, content and implementation strategies of written policies on end-of-life decisions in Flemish residential care facilities (RCFs) accommodating persons with intellectual disabilities (ID), and to describe training, education and quality assessments of end-of-life care.
A cross-sectional mail survey was conducted among general directors of all RCFs accommodating persons with ID (n = 140) in Flanders, Belgium. Institutions were asked to provide us with a copy of their end-of-life care policy documents for content analysis.
Of the 140 institutions, 84 (60%) completed the questionnaire and 25 institutions provided 45 policy documents. Presence of policies on specific end-of-life decisions with a possible life-shortening effect lay between 18% (palliative sedation) and 26% (withdrawing or withholding of life-prolonging treatment). The content analysis showed that the focus in the majority of these policy documents is on palliative care, while end-of-life decisions with a possible life-shortening effect are mentioned but rarely elaborated on. Furthermore, few documents incorporate the distinctive features and needs of persons with ID regarding end-of-life care. On the other hand, half of the institutions trained and educated their professional care providers in some aspects of end-of-life care while one-third assessed the satisfaction of residents and families on several of these aspects. However, more than half reported explicitly that they have no plans for such assessments.
The presence of end-of-life care policies is low in Flemish RCFs and their content is not very specific for persons with ID.
本文旨在描述在佛兰芒地区为智障人士提供居住护理服务的护理机构（RCF）中，存在、内容和实施临终决策书面政策的策略，并描述临终关怀的培训、教育和质量评估。
对佛兰芒地区所有为智障人士提供居住护理服务的 RCF 的院长进行了横断面邮寄问卷调查（n=140）。要求机构向我们提供其临终关怀政策文件的副本，以便进行内容分析。
在 140 家机构中，84 家（60%）完成了问卷调查，25 家机构提供了 45 份政策文件。对可能缩短生命的特定临终决策的政策存在率在 18%（姑息性镇静）至 26%（停止或不进行延长生命的治疗）之间。内容分析显示，这些政策文件的重点大多放在姑息治疗上，而可能缩短生命的临终决策只是被提及，但很少详细说明。此外，很少有文件将智障人士临终关怀的独特特征和需求纳入其中。另一方面，一半的机构对其专业护理人员进行了临终关怀方面的培训和教育，三分之一的机构评估了居民和家属对这些方面的满意度。然而，超过一半的机构明确表示他们没有计划进行此类评估。
佛兰芒 RCF 中临终关怀政策的存在率较低，其内容对智障人士来说并不十分具体。
