University of Ibadan, Ibadan, Nigeria.
BMC Med Ethics. 2022 Aug 25;23(1):87. doi: 10.1186/s12910-022-00825-5.
The study evaluated nurses' perceptions on the benefits, drawbacks, and their roles in initiating and implementing advance directives (AD) at private and public secondary healthcare units.
The study adopted a cross-sectional, comparative-descriptive research design and was anchored on the structural functional theory. A total of 401 nurses (131 private and 270 public) were chosen on purpose. The data was collected between January and March 2018 among nurses at the selected hospitals. Analysis was done via SPSSv28.0.1.0.
Compared to nurses working in private healthcare facilities (72.5%), the majority of nurses at the public healthcare facilities (75.2%) indicated a more favorable opinion of AD's benefits and (61.9%) felt they had a substantial involvement in the development and execution of AD than their private counterpart (56.5%). Similarly, 60.7% of nurses employed by the government agreed that AD has some disadvantages compared to those employed by the private sector (58.8%). Significantly, Christian nurses are 0.53 times less likely than Muslims to contest AD's benefits; 0.78 times less likely than Muslim to disagree that AD has flaws; and 1.30 times more likely than Muslim nurses to deny they contributed to the development and execution of AD, though not significant.
Making decisions at the end-of-life can be challenging, thus AD should be supported across the board in the healthcare industry. Nurses should be trained on their role in developing and implementing AD, as well as on its advantages and how to deal with its challenges.
本研究评估了护士对私立和公立二级医疗机构启动和实施预先指示(AD)的益处、弊端及其角色的看法。
本研究采用了横断面、比较描述性研究设计,并以结构功能理论为基础。共有 401 名护士(私立医院 131 名,公立医院 270 名)被选为研究对象。数据于 2018 年 1 月至 3 月期间在选定医院的护士中收集。使用 SPSSv28.0.1.0 进行分析。
与在私立医疗机构工作的护士(72.5%)相比,公立医院的护士(75.2%)更倾向于认为 AD 的益处更大,且(61.9%)认为他们在 AD 的制定和执行中发挥了重要作用,这一比例高于私立医院的护士(56.5%)。同样,与私营部门的护士相比,受雇于政府的护士(60.7%)认为 AD 存在一些缺点,而受雇于私营部门的护士(58.8%)则认为 AD 存在一些缺点。具有显著意义的是,与穆斯林护士相比,基督教护士认为 AD 有益的可能性低 0.53 倍;认为 AD 存在缺陷的可能性低 0.78 倍;否认他们对 AD 的制定和执行有贡献的可能性高 1.30 倍,尽管这一差异并不显著。
在生命末期做出决策可能具有挑战性,因此应在整个医疗保健行业中支持 AD。护士应接受关于其在制定和实施 AD 方面的角色、其优势以及如何应对其挑战的培训。