Schubart Jane R, Levi Benjamin H, Dellasega Cheryl, Whitehead Megan, Green Michael J
J Psychosoc Nurs Ment Health Serv. 2014 Feb;52(2):38-44. doi: 10.3928/02793695-20131028-01. Epub 2013 Nov 7.
This study identifies factors that affect decisions people make regarding whether they want to receive life-sustaining treatment. It is an interpretive-descriptive study based on qualitative data from three focus groups (N = 23), representing a diverse population in central Pennsylvania. Study sites included a suburban senior center serving a primarily White, middle-class population; an urban senior center serving a frail, underserved, African American population; and a breast cancer support group. The most important factors affecting whether participants wished to receive life-sustaining medical treatment were prognosis, expected quality of life, burden to others, burden to oneself in terms of the medical condition and treatment, and effect on mental functioning and independence. Our findings contribute to the knowledge of the complex factors that influence how people make decisions about advance care planning and life-sustaining treatments. This understanding is critical if nurses are to translate the patient's goals, values, and preferences into an actionable medical plan.
本研究确定了影响人们在是否希望接受维持生命治疗方面所做决定的因素。这是一项基于三个焦点小组(N = 23)定性数据的解释性描述性研究,这些焦点小组代表了宾夕法尼亚州中部的不同人群。研究地点包括一个主要服务于白人中产阶级人群的郊区老年中心;一个服务于体弱、未得到充分服务的非裔美国人人群的城市老年中心;以及一个乳腺癌支持小组。影响参与者是否希望接受维持生命医疗治疗的最重要因素是预后、预期生活质量、对他人的负担、就医疗状况和治疗而言对自身的负担,以及对心理功能和独立性的影响。我们的研究结果有助于了解影响人们在预先护理计划和维持生命治疗方面做出决策的复杂因素。如果护士要将患者的目标、价值观和偏好转化为可行的医疗计划,这种理解至关重要。