Jeong Sarah, Ohr Seok, Pich Jacqueline, Saul Peter, Ho Alan
The School of Nursing & Midwifery, The University of Newcastle, Ourimbah, NSW, Australia.
J Clin Nurs. 2015 Jan;24(1-2):244-55. doi: 10.1111/jocn.12649. Epub 2014 Jul 12.
To explore preparedness of end-of-life care planning among community-dwelling older persons of culturally and linguistically diverse background.
To improve end-of-life care through advance care planning, the key concept 'Planning ahead' has been promoted in Australia. However, since the introduction of the model in 2008, it is not known whether 'Planning Ahead' practice by older people from culturally and linguistically diverse backgrounds has improved.
A cross-sectional survey.
A total of 453 community older adults (65+) who attended 17 day care centres in a region were invited to participate in the study. A total of 229 people completed the survey with a response rate of 50·5%. The questions relevant to this study include: (1) awareness of enduring guardian, advance care directive and advance care planning, (2) the preference for substitute decision-makers and (3) the challenges experienced with advance care planning.
Awareness of advance care planning was low, and completion of advance care directive was very low. 37·5% of Anglo Celtic group had an enduring guardian, compared with 15·5, 24·1 and 13·3% from Mediterranean, Eastern European and Asia/Pacific group, respectively. Children were the most preferred substitute decision-makers more for Asia/Pacific group than Anglo Celtic, Mediterranean and Eastern Europeans. The various difficulties experienced included being time-consuming, difficult to understand terms and forms, and do not know how to do it.
Regardless of cultural and ethnic backgrounds, a low level of 'Planning ahead' practices was apparent because of a lack of understanding of the concept, the forms and the processes involved. The gap identified between the existing legal/ethical frameworks and the preferences of older people as substitute decision-makers adds new knowledge for further discussion.
Nursing professionals are provided with an opportunity to improve their practice to meet the needs of older persons and their families in planning ahead for future treatment options.
探讨具有文化和语言背景多样性的社区居家老年人临终关怀规划的准备情况。
为通过预先护理规划改善临终关怀，澳大利亚推广了关键概念“提前规划”。然而，自2008年引入该模式以来，尚不清楚具有文化和语言背景多样性的老年人的“提前规划”实践是否有所改善。
横断面调查。
邀请了某地区17个日间护理中心的453名社区老年人（65岁以上）参与研究。共有229人完成了调查，回复率为50.5%。与本研究相关的问题包括：（1）对持久监护人、预先护理指示和预先护理规划的知晓情况，（2）对替代决策者的偏好，以及（3）预先护理规划中遇到的挑战。
预先护理规划的知晓率较低，预先护理指示的完成率非常低。盎格鲁凯尔特人组中有37.5%的人有持久监护人，相比之下，地中海、东欧和亚太组的这一比例分别为15.5%、24.1%和13.3%。亚太组比盎格鲁凯尔特人、地中海和东欧组更倾向于选择子女作为替代决策者。遇到的各种困难包括耗时、条款和表格难以理解以及不知道如何进行。
无论文化和种族背景如何，由于对概念、表格和相关流程缺乏理解，“提前规划”实践水平较低。现有法律/伦理框架与老年人作为替代决策者的偏好之间的差距为进一步讨论增添了新知识。
为护理专业人员提供了一个改进实践的机会，以满足老年人及其家庭对未来治疗选择进行提前规划的需求。
