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医疗服务提供者在就预先医疗指示对患者进行教育方面的态度、知识和实践行为:一项全国性调查。

Healthcare Providers' Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey.

作者信息

Nedjat-Haiem Frances R, Cadet Tamara J, Amatya Anup, Mishra Shiraz I

机构信息

1 School of Social Work, New Mexico State University, Las Cruces, NM, USA.

2 School of Social Work, Simmons College, Boston, MA, USA.

出版信息

Am J Hosp Palliat Care. 2019 May;36(5):387-395. doi: 10.1177/1049909118813720. Epub 2018 Nov 28.

Abstract

BACKGROUND

: Advance care planning for end-of-life care emerged in the mid-1970's to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers.

OBJECTIVE

: Study aims examine providers' perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation.

DESIGN

: To examine providers' views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment.

METHODS

: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers' views toward AD education.

RESULTS

: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs.

CONCLUSION

: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.

摘要

背景

临终关怀的预先护理计划于20世纪70年代中期出现,以满足对诸如预先指示(AD)法律文件等工具的需求,以指导重症患者、其家属和医疗服务提供者之间的医疗决策。

目的

本研究旨在探讨医疗服务提供者对AD教育的看法,包括研究(1)对患者教育的一系列态度,(2)先前知识是否与患者教育中的实践行为相关,以及(3)医疗服务提供者中的特定因素,如工作环境特征、知识、态度和行为,这些因素可能影响AD教育和文件记录。

设计

为了研究医疗服务提供者的观点,我们通过社交媒体招募方法对医疗服务提供者进行了一项横断面在线调查问卷。

方法

本研究采用横断面调查设计来检验提出的目标。通过广泛的滚雪球方法招募医疗服务提供者,邀请他们参与在线调查。使用逻辑回归分析来研究医疗服务提供者对AD教育的看法。

结果

在520名参与者中,研究结果表明,大多数医疗服务提供者表示他们对AD教育有一定了解。他们还认为提供教育对他们的实践有益。这些结果表明,对AD教育持积极态度且遇到较少组织障碍的医疗服务提供者更有可能就AD对患者进行教育。

结论

本研究涵盖了多个学科,这表明态度和知识会影响AD讨论。医疗服务提供者发起AD讨论对于提供以患者为中心的最佳护理至关重要。

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