德国姑息治疗专家关于预立医疗指示的经验调查。
Survey on German Palliative Care Specialists' Experiences with Advance Directives.
作者信息
Zenz Julia, Zenz Michael
机构信息
Ruhr-University Bochum, Kemnaderstr. 342, 44797, Bochum, Germany.
Ruhr-University Bochum, Henkenbergstr. 63, 44797, Bochum, Germany.
出版信息
Pain Ther. 2017 Jun;6(1):17-28. doi: 10.1007/s40122-016-0063-0. Epub 2016 Nov 29.
INTRODUCTION
Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD).
METHODS
A questionnaire was handed out to attendants of a palliative care symposium.
RESULTS
Complete answers were obtained from 126 physicians and 276 nurses. Almost all physicians and nurses had treated patients with an AD, and the majority more than 10 patients. The most frequent refusal by the patients was resuscitation (87.8%) followed by intensive care (79.1%), artificial ventilation, and nutrition. The most frequent wish was pain therapy (92.3%) followed by allowing the natural course of the illness (64.4%). The wish for hospice treatment (44.8%) or spiritual care (39.3%) was less frequent.
DISCUSSION
The results hint at fears and deficits in the care of patients at the end of life. Often the quality of life and not the quantity of days remaining is in the center of a patient's will and points to the growing importance of palliative care.
CONCLUSION
ADs are well established among palliative care professionals and regarded as helpful for patients at the end of life.
引言
预立医疗指示在临终治疗、重症监护和姑息治疗中发挥着核心作用。然而，对于医护人员在预立医疗指示方面的经历却知之甚少。本研究报告了姑息治疗专业人员对预立医疗指示的看法。
方法
向姑息治疗研讨会的参会人员发放了问卷。
结果
共获得126名医生和276名护士的完整回答。几乎所有医生和护士都曾治疗过有预立医疗指示的患者，大多数人治疗过10名以上患者。患者最常拒绝的是心肺复苏（87.8%），其次是重症监护（79.1%）、人工通气和营养支持。最常见的愿望是疼痛治疗（92.3%），其次是顺其自然（64.4%）。希望接受临终关怀治疗（44.8%）或精神关怀（39.3%）的情况较少。
讨论
结果暗示了临终患者护理中的恐惧和不足。通常，患者意愿的核心是生活质量而非剩余天数，这表明姑息治疗的重要性日益凸显。
结论
预立医疗指示在姑息治疗专业人员中已得到广泛认可，并被视为对临终患者有帮助。
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