1 Division of Primary Care and Population Health, Center of Population Health Sciences, Stanford University School of Medicine , Stanford, California.
2 VA Palo Alto Health Care System , Palo Alto, California.
J Palliat Med. 2018 May;21(5):652-658. doi: 10.1089/jpm.2017.0512. Epub 2018 Feb 8.
To provide preference-sensitive care, we propose that clinicians might routinely inquire about their patients' bucket-lists and discuss the impact (if any) of their medical treatments on their life goals.
This cross-sectional, mixed methods online study explores the concept of the bucket list and seeks to identify common bucket list themes. Data were collected in 2015-2016 through an online survey, which was completed by a total of 3056 participants across the United States. Forty participants who had a bucket list were identified randomly and used as the development cohort: their responses were analyzed qualitatively using grounded theory methods to identify the six key bucket list themes. The responses of the remaining 3016 participants were used for the validation study. The codes identified from the development cohort were validated by analyses of responses from 50 randomly drawn subjects from the validation cohort. All the 3016 validation cohort transcripts were coded for presence or absence of each of the six bucket list themes.
Around 91.2% participants had a bucket list. Age and spirituality influence the patient's bucket-list. Participants who reported that faith/religion/spirituality was important to them were most likely (95%) to have a bucket list compared with those who reported it to be unimportant (68.2%), χ = 37.67. Six primary themes identified were the desire to travel (78.5%), desire to accomplish a personal goal (78.3%), desire to achieve specific life milestones (51%), desire to spend quality time with friends and family (16.7%), desire to achieve financial stability (24.3%), and desire to do a daring activity (15%).
The bucket list is a simple framework that can be used to engage patients about their healthcare decision making. Knowing a patient's bucket list can aid clinicians in relating each treatment option to its potential impact (if any) on the patient's life and life goals to promote informed decision making.
为了提供偏好敏感的护理，我们建议临床医生可以常规询问患者的遗愿清单，并讨论其医疗治疗对其生活目标的影响（如果有的话）。
本横断面混合方法在线研究探讨了遗愿清单的概念，并试图确定常见的遗愿清单主题。数据于 2015-2016 年通过在线调查收集，共有来自美国各地的 3056 名参与者完成了调查。随机确定了 40 名有遗愿清单的参与者作为开发队列：使用扎根理论方法对他们的回答进行定性分析，以确定六个关键的遗愿清单主题。剩余的 3016 名参与者的回答用于验证研究。从开发队列中确定的代码通过对验证队列中 50 名随机抽取的受试者的回答进行分析进行验证。验证队列中的所有 3016 个转录本都对六个遗愿清单主题中的每一个进行了存在或不存在的编码。
约 91.2%的参与者有遗愿清单。年龄和灵性影响患者的遗愿清单。与报告信仰/宗教/灵性对他们不重要的参与者（68.2%）相比，报告信仰/宗教/灵性对他们重要的参与者（95%）更有可能拥有遗愿清单，χ=37.67。确定了六个主要主题：旅行愿望（78.5%）、完成个人目标的愿望（78.3%）、实现特定生活里程碑的愿望（51%）、与朋友和家人共度美好时光的愿望（16.7%）、实现财务稳定的愿望（24.3%）和进行冒险活动的愿望（15%）。
遗愿清单是一个简单的框架，可以用来让患者参与他们的医疗保健决策。了解患者的遗愿清单可以帮助临床医生将每种治疗选择与其对患者生活和生活目标的潜在影响（如果有的话）联系起来，以促进知情决策。
