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家庭替代决策者在癌症终末期治疗中的决策冲突:一项横断面调查。

Decisional conflict in end-of-life cancer treatment among family surrogates: A cross-sectional survey.

作者信息

Jeon Bo Min, Kim Su Hyun, Lee Soo Jung

机构信息

College of Nursing, Kyungpook National University, Daegu, South Korea.

Department of Oncology/Hematology, Kyungpook National University Medical Center, Daegu, South Korea.

出版信息

Nurs Health Sci. 2018 Dec;20(4):472-478. doi: 10.1111/nhs.12537. Epub 2018 Jun 19.

Abstract

The aims of this study were to examine the extent of decisional conflict in end-of-life cancer treatments and to investigate the influences and predictors of decisional conflict among family surrogates. A cross-sectional, descriptive, correlational design was applied. Data were collected from a convenience sample of 102 family members who had participated in end-of-life cancer decision-making. We enrolled participants from inpatient oncology units at a university hospital in South Korea from May 2014 to January 2016. The results indicated that many family surrogates had high levels of decisional conflict and psychological stress after end-of-life cancer decision-making. Hierarchical multiple regression analyses demonstrated that decisional conflict had significant, substantial influences on decision regret and psychological stress after controlling for demographic variables. Family surrogates who were aware of the patients' wishes about end-of-life treatments and those who had good family functioning had less decisional conflict. To relieve decisional conflict regarding end-of-life cancer treatment among family surrogates, it is necessary to encourage patients to share their end-of-life treatment wishes with family members and to consider family functioning in the end-of-life decision-making process.

摘要

本研究的目的是考察临终癌症治疗中决策冲突的程度,并调查家庭替代决策者中决策冲突的影响因素和预测因素。采用了横断面、描述性、相关性设计。数据收集自102名参与临终癌症决策的家庭成员的便利样本。我们于2014年5月至2016年1月在韩国一家大学医院的住院肿瘤科招募了参与者。结果表明,许多家庭替代决策者在临终癌症决策后存在高水平的决策冲突和心理压力。分层多元回归分析表明,在控制人口统计学变量后,决策冲突对决策后悔和心理压力有显著且实质性的影响。知晓患者临终治疗意愿的家庭替代决策者以及家庭功能良好的决策者决策冲突较少。为减轻家庭替代决策者在临终癌症治疗方面的决策冲突,有必要鼓励患者与家庭成员分享其临终治疗意愿,并在临终决策过程中考虑家庭功能。

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