目标关怀对话及其后续的痴呆症患者的预先护理计划结果。
Goals of Care Conversations and Subsequent Advance Care Planning Outcomes for People with Dementia.
机构信息
University of California, San Francisco School of Medicine, San Francisco, CA, USA.
Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA.
出版信息
J Alzheimers Dis. 2021;83(4):1767-1773. doi: 10.3233/JAD-210720.
BACKGROUND
Advance care planning has been shown to improve end of life decision-making for people with dementia. However, the impact of goals of care conversations between people with dementia and their caregivers has not been characterized.
OBJECTIVE
In this study, we evaluate the association between goals of care conversations and advance care planning outcomes.
METHODS
Retrospective advance care planning measures were collected via a questionnaire administered to 166 caregivers after the death of the person with dementia for whom they provided care.
RESULTS
At time of death, the majority of decedents with dementia had advance directives, health care agents, and previous goals of care conversations with their caregiver. Goals of care conversations were significantly associated with the perceived usefulness of advance directives, the perceived adherence to advance directives, and decedent dying at their desired place of death, but not with disagreements around end-of-life care.
CONCLUSION
Our findings suggest that goals of care conversations are an important component of advance care planning. These findings support the development of interventions that facilitate such conversations between people with dementia and their caregivers.
背景
预先护理计划已被证明可以改善痴呆症患者的临终决策。然而，痴呆症患者与其护理人员之间的护理目标对话的影响尚未得到描述。
目的
在这项研究中，我们评估了护理目标对话与预先护理计划结果之间的关联。
方法
通过向为其提供护理的痴呆症患者的 166 名护理人员在患者去世后进行问卷调查，收集回顾性预先护理计划措施。
结果
在死亡时，大多数痴呆症患者都有预先指示、医疗代理人和与护理人员的先前护理目标对话。护理目标对话与预先指示的有用性感知、预先指示的遵守情况以及患者在期望的地点死亡显著相关，但与临终关怀的分歧无关。
结论
我们的发现表明，护理目标对话是预先护理计划的重要组成部分。这些发现支持开发干预措施，以促进痴呆症患者及其护理人员之间的此类对话。
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