Pérez M, Herreros B, Martín M D, Molina J, Guijarro C, Velasco M
Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, España.
Rev Calid Asist. 2013 Sep-Oct;28(5):307-12. doi: 10.1016/j.cali.2013.03.008. Epub 2013 Sep 7.
Advance directives (ADs), are documents in which patients express in advance that their wishes are fulfilled when they are unable to communicate them. It is unknown whether patients admitted to internal medicine are more aware of and make ADs.
To study the changes in the level of knowledge and implementation of AD among patients admitted to an internal medicine department of a hospital in Madrid since a specific regulation to implement them was introduced.
A survey was conducted among patients admitted to internal medicine in two periods: 2008 and 2010.
A total of 206 surveys were analysed (84 in 2008 and 122 in 2010). The mean age of the patients was 76.8 years, and 51.5% were women. More than two-thirds (69.4%) had a co-morbidity. and 4.4% had a terminal illness, with no statistical differences between the periods. Only 5.3% knew what ADs are, 1 had implemented ADs, and 46.1%, once informed, would like to implement them. There were no differences between 2008 and 2010 as regards knowledge and implementation of AD. In 2010 there was a greater interest to implement them (would like to implement them: 52.5 vs 36.9%), although in 2010 less respondents believe that AD would change the attitude of the doctor (not change the attitude: 92.6 vs. 69%, P<.001).
Knowledge and implementation of AD did not change significantly in the years following the regulation (from 2008-2010). In both periods, their knowledge and implementation are scarce.
预立医疗指示(ADs)是患者提前表达当自身无法表达意愿时希望其意愿得到满足的文件。尚不清楚内科住院患者对预立医疗指示是否有更高的认知度并制定此类指示。
研究自引入一项实施预立医疗指示的具体规定以来,马德里一家医院内科住院患者对预立医疗指示的认知水平和实施情况的变化。
在两个时间段(2008年和2010年)对内科住院患者进行了一项调查。
共分析了206份调查问卷(2008年84份,2010年122份)。患者的平均年龄为76.8岁,51.5%为女性。超过三分之二(69.4%)的患者患有合并症,4.4%患有绝症,两个时间段之间无统计学差异。只有5.3%的患者知道预立医疗指示是什么,1名患者已实施预立医疗指示,46.1%的患者在被告知后表示愿意实施。2008年和2010年在预立医疗指示的认知和实施方面没有差异。2010年有更大比例的患者愿意实施(愿意实施:52.5%对36.9%),尽管2010年较少的受访者认为预立医疗指示会改变医生的态度(不会改变态度:92. vs. 69%,P<0.001)。
在该规定实施后的几年里(2008 - 2010年),预立医疗指示的认知和实施情况没有显著变化。在两个时间段,对其的认知和实施情况都很匮乏。