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接受预先医疗照护计划的中国石家庄年轻成年人:一项混合方法研究。

Acceptance of Advance Care Planning Among Young Adults in Shijiazhuang, China: A Mixed-Methods Study.

机构信息

School of Nursing, Hebei University of Chinese Medicine, Hebei, China.

Research Center on Combining Medical and Care Services for Seniors, Peking University, Beijing, China.

出版信息

Am J Hosp Palliat Care. 2023 Jun;40(6):644-651. doi: 10.1177/10499091221127983. Epub 2022 Sep 21.

Abstract

: In the event of accidental trauma, incurable disease and public health emergencies, young adults are unable to participate in their own medical decisions, family members face the huge decision-making pressure and medical resources of the society were unevenly distributed. : The purposes of this study is to investigate the Advanced Care Planning (ACP) acceptance and examine its influencing factors using sequential explanatory mixed methods in order to provide a basis for the formulation of later interventions. : A cross-sectional study of young adults (N = 785) and 12 other young adults from two other communities were investigated from January 2021 to February 2022. Descriptive statistics and multiple linear regressions were conducted. Content analysis was performed on the qualitative data. : The primary factors that contributed to the acceptance of ACP were the natural acceptance of death, being female, having a high level of education, having a loved one diagnosed with a chronic disease, and having heard of ACP. Among young adults, the acceptance of ACP may be impeded by a fear of the unknown nature of death, a poor understanding of ACP, and family-led decision-making. : Our study found that 77.1% had not heard of ACP before participating in the study and showed potential to accept ACP-related interventions. The study highlighted the importance of implementing regular young adult education courses, promoting routine ACP knowledge, individualized education, discussing family member's disease experiences, conducting family meetings, and identifying young adult responsibilities and roles in implement ACP for young adults in China.

摘要

在意外创伤、不治之症和公共卫生紧急情况下,年轻人无法参与自己的医疗决策,家庭成员面临巨大的决策压力,且社会的医疗资源分配不均。

本研究旨在通过顺序解释性混合方法调查年轻人对预先医疗指示(ACP)的接受程度,并探讨其影响因素,为以后的干预措施制定提供依据。

2021 年 1 月至 2022 年 2 月,对来自两个社区的 785 名年轻成年人和另外 12 名年轻成年人进行了横断面研究。采用描述性统计和多元线性回归进行分析。对定性数据进行内容分析。

促进 ACP 接受的主要因素包括对死亡的自然接受、女性、高教育水平、有亲人被诊断患有慢性病、听说过 ACP。在年轻人中,对 ACP 的接受可能会受到对死亡未知性质的恐惧、对 ACP 的理解不足以及家庭主导的决策的阻碍。

我们的研究发现,77.1%的年轻人在参与研究之前从未听说过 ACP,但表现出对 ACP 相关干预措施的潜在接受能力。该研究强调了在中国实施定期的年轻人教育课程、推广常规的 ACP 知识、个性化教育、讨论家庭成员的疾病经历、进行家庭会议以及确定年轻人在实施 ACP 方面的责任和角色的重要性。

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