Fegg Martin, Lehner Marc, Simon Steffen T, Gomes Barbara, Higginson Irene J, Bausewein Claudia
Klinik und Poliklinik für Palliativmedizin, Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Zentrum für Palliativmedizin, Universitätsklinikum Köln, Köln, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Oct;58(10):1118-23. doi: 10.1007/s00103-015-2219-1.
Because of demographic changes of an aging society, palliative care is becoming increasingly important. It is therefore necessary to evaluate preferences at the end of life at an early stage to meet the needs and requests of future patients.
The aim of this study was to find out preferences in a theoretical scenario ("If you developed a serious medical condition such as cancer and you had less than a year to live…") regarding the desired involvement in decision-making at the end of life and the preferred place of death.
As part of the international PRISMA project, a representative telephone survey was carried out in Germany.
A total of 1,363 Germans took part in the survey (response rate 29.0 %, 47.1 ± 15.7 years, 42 % male). 90.8 % wanted to make their own decisions with regard to end-of-life care, which was most important for people with higher education. 83.3 % wanted to predetermine decisions by means of an advance directive in case they are no longer able to make them at the time. This was again more important for individuals with higher education and for older subjects (≥ 65 years). The preferred place of death was their own home (63.3 %), and the least preferred place for death was in hospital in 48.2 %. In particular, women did not want to die in a hospital.
These results should be considered when planning health care structures to meet the wishes of people at the end of their life, in particular to strengthen the importance of patient provision and the desire for their own home to be the preferred place to die.
由于社会老龄化的人口结构变化,姑息治疗变得越来越重要。因此,有必要在早期阶段评估临终时的偏好,以满足未来患者的需求和请求。
本研究的目的是在一个理论场景(“如果你患上了严重的疾病,如癌症,且生命不足一年……”)中,了解人们在临终决策参与度和首选死亡地点方面的偏好。
作为国际PRISMA项目的一部分,在德国进行了一项具有代表性的电话调查。
共有1363名德国人参与了调查(回复率29.0%,年龄47.1±15.7岁,男性占42%)。90.8%的人希望在临终护理方面自己做决定,这对受过高等教育的人来说最为重要。83.3%的人希望通过预先指示来预先确定决策,以防他们当时无法做出决策。这对受过高等教育的人和老年受试者(≥65岁)来说同样更为重要。首选的死亡地点是自己家中(63.3%),最不希望的死亡地点是医院,占48.2%。特别是女性不想在医院死亡。
在规划医疗保健结构以满足人们临终愿望时,应考虑这些结果,特别是要强化患者护理的重要性以及希望自己家中成为首选死亡地点的愿望。