Skilled Geriatric Nursing Department, Herzog Hospital, Affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.
Arch Gerontol Geriatr. 2014 Jan-Feb;58(1):25-9. doi: 10.1016/j.archger.2013.08.004. Epub 2013 Sep 9.
In recent years personal and clinical dilemmas relating to terminally ill patient-care medical, decisions have increased significantly. Although understanding the patient's medical, nursing and, social background is important, a comprehensive appraisal essential for treating the "whole patient" is, incomplete without a spirituality assessment. Religious beliefs and practices affect medical and health, care decisions and require recognition as a dynamic in coping with suffering, loss, life, and death. Taking a spiritual background obtains information that is meaningful to the patient's life and may, influence the medical decision-making relating to health. A study was undertaken to determine, whether assessing the spiritual background influences medical decisions-making regarding the use of, DNR. The target population was 46 family-member caregivers of non-communicative patients in the Herzog, Hospital Skilled Nursing ward located in Jerusalem. The spiritual assessment questionnaire was the, acronym FICA (faith, importance, community and addressing). Two-thirds of the families were opposed to a determination utilizing do not resuscitate (DNR). Multivariate, analysis of the findings found that only religious affiliation was statistically significant (p=0.003). The doctors recommend DNR in 67% of the cases while the family caregiver accepted this decision in, only 33% of the cases. The hypothesis was verified. People who are perceived as being religious or as being greatly influenced, by faith/spirituality opposed the recommendation implementing DNR. Obtaining a spiritual background assists the physician to understand the patient or family spirituality, facilitates sensitivity to value frameworks and preferences in making medical and health-related, decisions.
近年来,与绝症患者医疗护理相关的个人和临床困境决策显著增加。尽管了解患者的医疗、护理和社会背景很重要,但全面评估对于治疗“整体患者”是不完整的,如果没有灵性评估。宗教信仰和实践会影响医疗和健康决策,需要认识到它们是应对痛苦、丧失、生命和死亡的动态因素。了解患者的灵性背景可以获取对其生活有意义的信息,并可能影响与健康相关的医疗决策。一项研究旨在确定评估灵性背景是否会影响关于使用 DNR 的医疗决策。目标人群是位于耶路撒冷的 Herzog 医院熟练护理病房中无法沟通的非传染性患者的 46 名家属护理人员。灵性评估问卷的缩写是 FICA(信仰、重要性、社区和处理)。三分之二的家庭反对使用不复苏(DNR)的决定。对调查结果的多变量分析发现,只有宗教信仰具有统计学意义(p=0.003)。医生建议在 67%的情况下使用 DNR,而家属护理人员仅在 33%的情况下接受这一决定。假设得到了验证。被认为是宗教人士或受信仰/灵性极大影响的人反对实施 DNR 的建议。获取灵性背景可以帮助医生了解患者或家庭的灵性,促进对价值框架和医疗健康相关决策中的偏好的敏感性。