University of Nebraska Medical Center, Omaha, NE 68198-7689, USA.
Leuk Lymphoma. 2011 Dec;52(12):2342-8. doi: 10.3109/10428194.2011.601474. Epub 2011 Aug 18.
This study evaluated whether measures of psychological well-being, including coping style, are associated with advance care planning (ACP). Data were from the Hematology Communications Study (HEMA-COMM), a prospective observational study of physician-patient communication in patients with hematologic malignancies. ACP was defined as having a living will, having a health care proxy, discussing life support with family or friends and discussing life support with a doctor or nurse. A total of 293 patients participated: only 45 (15%) had all the elements of ACP; 215 (73%) had at least one element of ACP, while 33 (11%) did not engage in ACP. In multivariate analysis, specific coping styles but not other measures of psychosocial well-being were associated with having written ACP. Verbal ACP was associated with patient-reported health and physician estimate of life expectancy. Our study suggests that tailoring ACP discussions to a patient's coping style may increase engagement in ACP.
本研究评估了心理幸福感的衡量标准，包括应对方式，是否与预先医疗指示（ACP）有关。数据来自血液学通讯研究（HEMA-COMM），这是一项对血液恶性肿瘤患者医患沟通的前瞻性观察性研究。ACP 的定义是有生前遗嘱、有医疗代理人、与家人或朋友讨论生命支持问题以及与医生或护士讨论生命支持问题。共有 293 名患者参与：仅有 45 名（15%）患者具备 ACP 的所有要素；215 名（73%）患者至少具备 ACP 的一个要素，而 33 名（11%）患者没有参与 ACP。在多变量分析中，特定的应对方式而不是其他心理社会幸福感的衡量标准与书面 ACP 有关。口头 ACP 与患者报告的健康状况和医生对预期寿命的估计有关。我们的研究表明，根据患者的应对方式调整 ACP 讨论可能会增加他们参与 ACP 的意愿。
