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美国肿瘤学家对预先指示使用情况的探索性研究。

An exploratory study of the use of advance directives by US oncologists.

作者信息

Sharma Umesh M, Schroeder Jonean E, Al-Hamadani Mohammed, Mathiason Michelle A, Meyer Christine M, Frisby Kathleen A, Meyer Lori A, Sieber Debbie L, Go Ronald S

出版信息

WMJ. 2013 Aug;112(4):158-61.

Abstract

PURPOSE

This study sought to determine the rate of advance directive completion among US oncologists and factors influencing such a decision.

METHODS

We surveyed 7590 members of the American Society of Clinical Oncology using a web-based questionnaire.

RESULTS

The response rate was 8.1%. Most respondents (59%) had completed at least 1 document: 9% living will, 9% power of attorney for health care, and 41% both. Respondents who were older, men, married, with children, working in the community setting, radiation oncologists, and practicing general oncology were more likely than their counterparts to have an advance directive. Among those who had one, 95% and 36% had discussed their wishes with their loved ones and health care providers, respectively. Factors including experience at work, spouse, children, family, and religion had the most influence on respondents' decision. The majority of those without an advance directive reported either no reason or lack of time. Those who had them were more likely to report having a comprehensive review of their wishes with those closest to them, being more knowledgeable, having more routine discussions with their patients, and being more comfortable helping their patients complete one.

CONCLUSION

Only about half of US oncologists who responded to our survey have completed an advance directive.

摘要

目的

本研究旨在确定美国肿瘤学家中预先医疗指示的完成率以及影响这一决定的因素。

方法

我们使用基于网络的问卷对美国临床肿瘤学会的7590名成员进行了调查。

结果

回复率为8.1%。大多数受访者(59%)至少完成了1份文件:9%完成了生前遗嘱,9%完成了医疗保健委托书,41%两者都完成了。年龄较大、男性、已婚、有子女、在社区工作、放射肿瘤学家以及从事普通肿瘤学工作的受访者比同行更有可能拥有预先医疗指示。在拥有预先医疗指示的人中,分别有95%和36%与他们的亲人及医疗保健提供者讨论过自己的意愿。工作经历、配偶、子女、家庭和宗教等因素对受访者的决定影响最大。大多数没有预先医疗指示的人表示没有理由或没有时间。拥有预先医疗指示的人更有可能报告与最亲近的人全面审查了自己的意愿、知识更丰富、与患者进行更多常规讨论以及更愿意帮助患者完成一份预先医疗指示。

结论

在回复我们调查的美国肿瘤学家中,只有大约一半完成了预先医疗指示。

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