Bryant Jamie, Sellars Marcus, Waller Amy, Detering Karen, Sinclair Craig, Ruseckaite Rasa, White Ben, Nolte Linda
Health Behaviour Research Collaborative,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
School of Medicine and Public Health, Health Behaviour Research Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia.
BMJ Support Palliat Care. 2021 Mar 3;12(e3):e464-8. doi: 10.1136/bmjspcare-2020-002550.
To describe among individuals with dementia: (1) self-reported awareness of, and engagement in, advance care planning; (2) presence of advance care planning documentation in the health record and (3) concordance between self-reported completion of advance care planning and presence of documentation in the health record.
An Australian prospective multicentre audit and cross-sectional survey. Individuals diagnosed with dementia who were able to speak English and were judged by a healthcare provider as having decision-making capacity were recruited from self-selected hospitals, residential aged care facilities and general practices across Australia.
Fifty-two people with dementia completed surveys and were included. Overall, 59.6% of participants had heard about advance care planning and 55.8% had discussed advance care planning with someone, most often a family member (48.1%). While 38.5% of participants had appointed a medical substitute decision maker, only 26.9% reported that they had written down their values and preferences for future care. Concordance between self-reported completion of advance care planning and presence of documentation in the health record was low (56.8%, κ0.139; 57.7%, κ0.053).
Effective models that promote discussion, documentation and accessible storage of advance care planning documents for people with dementia are needed.
描述患有痴呆症的个体中：（1）自我报告的对预先护理计划的知晓程度及参与情况；（2）健康记录中预先护理计划文件的存在情况；以及（3）自我报告的预先护理计划完成情况与健康记录中文件存在情况之间的一致性。
一项澳大利亚前瞻性多中心审计和横断面调查。从澳大利亚各地自我选择的医院、老年护理机构和全科诊所招募被诊断患有痴呆症、能说英语且经医疗服务提供者判断具有决策能力的个体。
52名患有痴呆症的人完成了调查并被纳入研究。总体而言，59.6%的参与者听说过预先护理计划，55.8%的人曾与他人讨论过预先护理计划，其中最常讨论的对象是家庭成员（48.1%）。虽然38.5%的参与者指定了医疗替代决策者，但只有26.9%的人报告称他们已写下自己对未来护理的价值观和偏好。自我报告的预先护理计划完成情况与健康记录中文件存在情况之间的一致性较低（56.8%，κ值为0.139；57.7%，κ值为0.053）。
需要有效的模式来促进为痴呆症患者进行预先护理计划文件的讨论、记录及便捷存储。
