Harringer Wilfried
Facharzt Allgemeine Medizin FMH, Psychosomatische Medizin SAPPM, Goldach.
Ther Umsch. 2012 Feb;69(2):107-9. doi: 10.1024/0040-5930/a000260.
View the fact of a doubling percentage of people aged 80 and over in the coming 20 years the topic of advance directives (AD) will play a more important role in general practice. It is the task of the GP as the integrating professional in any palliative care network to provide discussion and advice and to collaborate with the patient for a reliable version. Formulating AD's in principal means a life long process respectfully accompanied by the GP. By this approach AD's facilitate the discussion about taboos and serve as a valuable instrument for decision making, both for the patient and the GP. There are many reasons to address AD's in our daily clinical practice and to document it routinely in our medical charts as systematic as "allergies" or "vaccinations". From a recent study we learn that the most simple version of AD's is preferred by patients with 77 % of pre-existing and 81 % of newly written AD's consisting of one page only. Longer and more complex versions may produce fears.
鉴于在未来20年里80岁及以上人群的比例将翻倍这一事实，预立医疗指示（AD）在全科医疗中将发挥更重要的作用。作为任何姑息治疗网络中的整合专业人员，全科医生的任务是提供讨论和建议，并与患者合作制定一份可靠的预立医疗指示。制定预立医疗指示原则上意味着一个由全科医生全程尊重陪伴的终身过程。通过这种方式，预立医疗指示有助于打破禁忌的讨论，并成为患者和全科医生决策的宝贵工具。在我们的日常临床实践中，有很多理由提及预立医疗指示，并像记录“过敏史”或“疫苗接种情况”一样系统地将其常规记录在我们的病历中。从最近的一项研究中我们了解到，患者更喜欢最简单版本的预立医疗指示，77%的已有预立医疗指示和81%的新写预立医疗指示都只有一页。更长、更复杂的版本可能会引发恐惧。
