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社区健康对话对预先医疗照护计划态度和准备意愿的影响。

Impact of a community health conversation upon advance care planning attitudes and preparation intentions.

机构信息

Division of Geriatric and Palliative Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, USA.

Department of Medicine, Northwell Health, Manhasset, New York, USA.

出版信息

Gerontol Geriatr Educ. 2021 Jan-Mar;42(1):82-95. doi: 10.1080/02701960.2020.1739670. Epub 2020 Mar 29.

Abstract

: Advance care planning conversations and preparations do not occur as frequently as they should. Framing advance care planning as a health behavior and an opportunity for community engagement can help improve community-dwellers' intentions to have discussions and preparations regarding facing serious illness, death and dying.: A multi-setting confidential pre/post paper survey assessing advance care planning discussions and preparation intentions was given to community-dwelling citizens residing in the New York metropolitan area. Survey items were adapted from a previous end of life survey to include questions on chronic illnesses, important conversations, comfort levels and concerns about end of life. The intervention was a 1-hour presentation on advance care planning (importance, laws, effective communication and audience questions): Our study found significant interest in discussing advanced care planning across age groups. There were significant changes for participant intentions regarding: having conversations with loved ones, a health care proxy or similar document and none; as well as differences in participant intentions for discussions with caregiver, family, friends, primary physician and no-one.: Educating individuals on the importance of advance care planning may be effective in changing community dwellers' intentions to start the conversation and put advanced care planning measures in place. ACP: Advance Care Planning; CHAT: Conversations Health and Treatments; EoL: End of Life; HCP: Health Care Proxy; MOLST: Medical Orders for Life-Sustaining Treatments; PCP: Primary Care Physician.

摘要

: 预先医疗护理计划的谈话和准备工作并没有像应该的那样频繁进行。将预先医疗护理计划视为一种健康行为和社区参与的机会,可以帮助提高社区居民对面临严重疾病、死亡和临终的讨论和准备的意愿。: 一项多环境保密的预/后纸质调查评估了预先医疗护理计划的讨论和准备意愿,该调查面向居住在纽约大都市区的社区居民。调查项目改编自以前的临终调查,包括关于慢性病、重要谈话、舒适水平和对临终关怀的关注的问题。干预措施是关于预先医疗护理计划的 1 小时演示(重要性、法律、有效沟通和受众问题):: 我们的研究发现,不同年龄段的人都对讨论预先医疗护理计划表现出浓厚的兴趣。在与亲人、医疗保健代理人或类似文件进行对话以及与护理人员、家人、朋友、初级保健医生和无人进行对话的意愿方面,参与者的意图发生了显著变化。: 教育个人预先医疗护理计划的重要性可能会有效地改变社区居民开始对话和实施预先医疗护理计划措施的意愿。ACP:预先医疗护理计划;CHAT:对话健康和治疗;EoL:生命末期;HCP:医疗保健代理人;MOLST:维持生命治疗的医疗指令;PCP:初级保健医生。

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