预先护理计划：优质的临终关怀真的那么简单吗？

Advance Care Planning: is quality end of life care really that simple?

作者信息

Johnson Stephanie, Kerridge Ian, Butow Phyllis N, Tattersall Martin H N

机构信息

Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.

Centre for Values, Ethics and the Law in Medicine (Velim), School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Intern Med J. 2017 Apr;47(4):390-394. doi: 10.1111/imj.13389.

DOI:10.1111/imj.13389

PMID:28401724

Abstract

The routine implementation of Advance Care Planning (ACP) is now a prominent feature of policy directed at improving end of life care in Australia. However, while complex ACP interventions may modestly reduce medical care at the end of life and enable more people to die at home or outside of acute hospital settings, existing legal, organisational, cultural and conceptual barriers limit the implementation and utility of ACP. We suggest that meaningful improvements in end of life care will not result from the institutionalisation of ACP but from more significant changes to the design and delivery of care.

摘要

预先护理计划（ACP）的常规实施如今已成为澳大利亚旨在改善临终护理的政策的一个显著特征。然而，尽管复杂的ACP干预措施可能会适度减少临终时的医疗护理，并使更多人能够在家中或急性医院环境之外离世，但现有的法律、组织、文化和概念障碍限制了ACP的实施和效用。我们认为，临终护理的切实改善并非源于ACP的制度化，而是源于护理设计和提供方面更重大的变革。