临终关怀中不同和脆弱患者群体的 ICD 知识和态度。
ICD Knowledge and Attitudes at End of Life in a Diverse and Vulnerable Patient Population.
出版信息
J Health Care Poor Underserved. 2022;33(4):1793-1808. doi: 10.1353/hpu.2022.0138.
BACKGROUND
Studies thus far lacking diversity show many patients with implantable cardioverter defibrillators (ICDs) have poor understanding of ICD functioning, preventing informed decision-making near end of life (EOL).
OBJECTIVE
To describe knowledge, perceptions, and preferences regarding ICDs among patients nearing EOL in a diverse, safety-net hospital population.
METHODS
A cross sectional phone survey of patients with ICDs nearing EOL from a safety-net hospital was performed. The survey assessed knowledge, perceptions, and preferences regarding their ICD.
RESULTS
Nearly half (46%) of patients falsely believed turning off shocking function would stop the heart, 69% were unaware that disabling ICDs does not require surgery, and 88% said no doctor had ever discussed the option of deactivation of shocking therapy with them.
CONCLUSION
Challenges in health care delivery in a safety-net hospital patient population may result in patients being poorly equipped to align ICD settings with goals of care when nearing EOL.
背景
迄今为止，缺乏多样性的研究表明，许多植入式心脏复律除颤器（ICD）患者对 ICD 的功能了解不足，这妨碍了他们在生命末期（EOL）做出明智的决策。
目的
描述在一个多样化的、以保障基本医疗服务为主的医院人群中，临近 EOL 的患者对 ICD 的知识、看法和偏好。
方法
对一家以保障基本医疗服务为主的医院中临近 EOL 的 ICD 患者进行了一项横断面电话调查。该调查评估了他们对 ICD 的知识、看法和偏好。
结果
近一半（46%）的患者错误地认为关闭电击功能会停止心脏跳动，69%的患者不知道禁用 ICD 不需要手术，88%的患者表示没有医生曾经与他们讨论过停用电击治疗的选择。
结论
在以保障基本医疗服务为主的医院患者群体中，医疗服务提供方面的挑战可能导致患者在接近 EOL 时，无法很好地将 ICD 设置与治疗目标相匹配。
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