Zhang Weihua
Nell Hodgson Woodruff School of Nursing Emory University, 1520 Clifton Road, Atlanta, GA 30322-4207, USA.
J Aging Res. 2013;2013:470812. doi: 10.1155/2013/470812. Epub 2013 Dec 26.
Purpose. The purpose of this study was to identify variables that influenced completion of advanced directives in the context of adaptation from national data in older adults. Knowledge gained from this study would help us identify factors that might influence end of life discussions and shed light on strategies on effective communication on advance care planning. Design and Method. A model-testing design and path analysis were used to examine secondary data from 938 participants. Items were extracted from the data set to correspond to variables for this study. Scales were constructed and reliabilities were tested. Results. The final path model showed that physical impairment, self-rated health, continuing to work, and family structure had direct and indirect effects on completion of advanced directives. Five percent of the variance was accounted for by the path analysis. Conclusion. The variance accounted for by the model was small. This could have been due to the use of secondary data and limitations imposed for measurement. However, health care providers and families should explore patient's perception of self-health as well as their family and work situation in order to strategize a motivational discussion on advance directive or end of life care planning.
目的。本研究的目的是在根据老年人的全国性数据进行调整的背景下，确定影响预先指示完成情况的变量。从本研究中获得的知识将有助于我们识别可能影响临终讨论的因素，并阐明关于预先护理计划有效沟通的策略。设计与方法。采用模型测试设计和路径分析来检验来自938名参与者的二手数据。从数据集中提取项目以对应本研究的变量。构建量表并测试其信度。结果。最终路径模型表明，身体损伤、自评健康状况、继续工作和家庭结构对预先指示的完成有直接和间接影响。路径分析解释了5%的方差。结论。该模型解释的方差较小。这可能是由于使用了二手数据以及测量方面的限制。然而，医疗保健提供者和家庭应探索患者对自身健康的认知以及他们的家庭和工作状况，以便制定关于预先指示或临终护理计划的激励性讨论策略。
