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患者精神/宗教信仰与复苏决策的探索

Exploration of Patients' Spiritual/Religious Beliefs and Resuscitation Decisions.

作者信息

Freitas Elizabeth, Zhang Guangxiang

机构信息

The Queen's Medical Center, Honolulu, HI.

出版信息

Hawaii J Health Soc Welf. 2019 Jul;78(7):216-222.

Abstract

Artificial resuscitation has potential to reverse a premature death or to prolong the dying process. The resuscitation decision is one of life and death making it imperative that healthcare providers understand patients' beliefs. Making the decision to resuscitate has been associated with patients' spiritual/religious beliefs. Clinicians' assumptions based upon a patients' religion or spiritual beliefs may bias the resuscitation decision. The purpose of this study was to determine associations between hospitalized patients' spiritual/religious beliefs and their resuscitation decisions. A single-site, correlational study was conducted with a convenience sample of hospitalized patients in Honolulu, HI. Patients were enrolled November 2015 to January 2016. Spiritual/religious beliefs were assessed using two validated metrics. Two questions were used to determine the resuscitation decision (chest compressions and intubation). The sample of 84 patients represented no ethnic majority among Caucasian, Asian, and Native Hawaiian/Pacific Islander. Seventy-nine percent of the participants identified theistic spiritual beliefs. No associations were found between resuscitation decisions with either spiritual/religious beliefs or demographic characteristics of this study sample. Interestingly, 20% of the participants answered yes to only one of the resuscitation decision questions. Thus, providers' assumptions should not be made about an association between spiritual/religious beliefs and resuscitation decisions. It is imperative that patients are aware of the necessity for both medical interventions of chest compressions and intubation. Further research should address the complexity of the resuscitation decision, including patients understanding of medical interventions and anticipated prognosis, and other influencing factors.

摘要

人工复苏有可能逆转过早死亡或延长濒死过程。复苏决策是一个生死抉择,这使得医疗服务提供者了解患者的信念势在必行。做出复苏决定与患者的精神/宗教信仰有关。临床医生基于患者宗教或精神信仰的假设可能会使复苏决策产生偏差。本研究的目的是确定住院患者的精神/宗教信仰与其复苏决策之间的关联。在夏威夷檀香山对住院患者进行了一项单中心相关性研究,采用便利抽样法。患者于2015年11月至2016年1月入组。使用两个经过验证的指标评估精神/宗教信仰。用两个问题来确定复苏决策(胸外按压和插管)。84名患者的样本在白种人、亚洲人和夏威夷原住民/太平洋岛民中没有种族多数。79%的参与者认同有神论的精神信仰。在本研究样本中,未发现复苏决策与精神/宗教信仰或人口统计学特征之间存在关联。有趣的是,20%的参与者对复苏决策问题中只有一个回答是肯定的。因此,不应基于精神/宗教信仰与复苏决策之间的关联做出假设。患者必须了解胸外按压和插管这两种医疗干预措施的必要性。进一步的研究应解决复苏决策的复杂性,包括患者对医疗干预措施和预期预后的理解以及其他影响因素。

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