Albayrak Turgay, Şencan İrfan, Akça Ömer, Koç Esra Meltem, Aksoy Hilal, Ünsal Selim, Bülbül İskender, Bahadır Adem, Kasım İsmail, Kahveci Rabia, Özkara Adem
Yenimahalle Cigdemtepe Family Health Center, Ankara, Turkey.
Ankara Numune Training and Research Hospital, Department of Family Medicine, Ankara, Turkey.
PLoS One. 2017 Jul 21;12(7):e0181456. doi: 10.1371/journal.pone.0181456. eCollection 2017.
The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment.
We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions.
The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013.
A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer's Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations.
The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided.
Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants' desire should be evaluated in terms of practicability.
民众参与健康决策可体现在多个层面。其中之一是参与治疗决策。“预先指令”就是参与治疗决策的一个例子。
我们想确定在患有危及生命疾病的生命末期，患者本人及其一级亲属对于高级生命支持的决策以及影响这些决策的因素。
本横断面研究于2012年12月15日至2013年3月15日期间，在除急诊、肿瘤和精神科门诊外，向安卡拉努穆内培训和研究医院所有门诊就诊的患者及患者亲属中的志愿者开展。
对所有个体应用一份问卷、医院焦虑抑郁量表（HAD）和坦普勒死亡焦虑量表（TDA）。所有统计分析和计算均使用适用于Windows的SPSS 17.0版软件包和MS-Excel 2010入门版软件包。
参与者希望自己及其一级亲属都能参与末期决策过程。因此，在决策过程中应充分告知患者及其家属，并必须提供高质量的沟通。
先前已做出末期决策的参与者希望按照这些决策接受治疗。只有通过预先指令，这种愿望才有可能实现。考虑到末期过程的道德和物质负担，应对实行预先指令的国家进行充分研究，并应从实用性角度评估参与者的愿望。
