Royal Surrey County Hospital, Guildford, UK.
Princess Alice Hospice, Esher, UK.
BMJ Support Palliat Care. 2019 Sep;9(3):340-345. doi: 10.1136/bmjspcare-2015-001085. Epub 2016 May 17.
The aim of this study was to investigate concordance between patients and non-professional carers about factors associated with a 'good death' and other end-of-life decisions.
Patients completed a questionnaire about end-of-life care issues, and were asked to rank the importance of factors linked to a 'good death'. Carers also completed a questionnaire about end-of-life care issues relating to the patient, and whether or not they agreed with those choices (ie, medical treatments, PPD). Carers were also asked to rank the importance of factors linked to a 'good death' to the patient, and to them personally at that point in time.
Only 69% of patients stated they had discussed their preferences for end-of-life care with their respective carer. The rankings were similar for the patient and the carer's views of what was important for the patient, although the patients ranked 'to be involved in decisions about my care' as less important than the carers, while the carers ranked 'to have sorted out my personal affairs' as less important than the patients.
When discussions around end-of-life choices do occur, carers generally appear to agree with the patients' preferences around end-of-life treatment, and preferred place of death.
本研究旨在调查患者和非专业护理人员对与“善终”相关因素及其他临终决策的一致性看法。
患者完成一份有关临终关怀问题的问卷,并被要求对与“善终”相关因素的重要性进行排序。护理人员也完成一份与患者临终关怀相关的问卷,并回答他们是否同意这些选择(即,医疗、PPD)。护理人员还被要求对与患者和他们个人在那个时间点的“善终”相关的因素的重要性进行排序。
只有 69%的患者表示他们与各自的护理人员讨论过临终关怀的偏好。尽管患者对“参与护理决策”的重要性评价低于护理人员,而护理人员对“整理个人事务”的重要性评价低于患者,但患者和护理人员对患者重要性的看法相似。
当围绕临终选择进行讨论时,护理人员通常似乎同意患者对临终治疗和首选死亡地点的偏好。