St. Gemma's Hospice, Leeds, UK.
J Pain Symptom Manage. 2011 Aug;42(2):192-201. doi: 10.1016/j.jpainsymman.2010.11.022. Epub 2011 Mar 27.
Artificial hydration (AH) is used to palliate patients with reduced fluid intake at the end of life but is a controversial practice. Patients' involvement in decision making varies, and little is known about patients' understanding of the benefits and burdens of AH.
To identify the factors that patients consider most important when making decisions regarding AH at the end of life.
Interview study using Q-sort methodology conducted with 20 patients with advanced diseases recruited from inpatient and outpatient palliative care services.
Several domains appear to influence a decision about AH: the patient's understanding of AH, their philosophical position on end-of-life care, the process of discussion, and who makes the final decision. Patients generally based their decision on whether AH would improve quality of life, although prolonging life was important for some. Hydration was not considered a burden, and many would want a trial of AH in the event that they could no longer drink. Patients wanted to be guided by medical opinion, although some wanted to make the decision on their own. All patients welcomed the opportunity to discuss AH.
Patients view AH as an important issue and are keen to be involved in decision making. Health care professionals may withhold AH at the end of life because they perceive it as a burden on patients and on their interactions with family, although this view is not shared by patients. Some patients lack understanding regarding the likely benefits of AH. Research examining the impact of clinical information regarding AH on patients' decision making is now needed.
人工补液（AH）用于缓解生命末期液体摄入减少的患者，但这是一种有争议的做法。患者在决策中的参与程度各不相同，对于患者对 AH 的益处和负担的理解知之甚少。
确定患者在生命末期做出关于 AH 的决策时最看重的因素。
采用 Q 分类方法对 20 名来自住院和门诊姑息治疗服务的晚期疾病患者进行访谈研究。
有几个领域似乎会影响 AH 的决策：患者对 AH 的理解、他们对临终关怀的哲学立场、讨论过程以及谁做出最终决定。尽管对一些患者来说延长生命很重要，但患者通常会根据 AH 是否能提高生活质量来做出决定。补液并不被认为是一种负担，许多患者希望在无法饮水时尝试 AH。患者希望听从医疗意见，但有些患者希望自己做出决定。所有患者都欢迎有机会讨论 AH。
患者认为 AH 是一个重要问题，并渴望参与决策。医疗保健专业人员可能会在生命末期停止 AH，因为他们认为 AH 对患者及其与家人的互动是一种负担，尽管患者并不这么认为。一些患者对 AH 的可能益处缺乏了解。现在需要研究关于 AH 的临床信息对患者决策的影响。
