养老院中患有和未患有痴呆症的临终居民的信息及预立医疗照护计划
Information and Advance Care Directives for End-of-Life Residents with and without Dementia in Nursing Homes.
作者信息
Mota-Romero Emilio, Rodríguez-Landero Olga, Moya-Dieguez Rocío, Cano-Garzón Glaucione Marisol, Montoya-Juárez Rafael, Puente-Fernández Daniel
机构信息
Andalusian Health Service District Metropolitano Granada, Salvador Caballero Primary Care Centre, Institute for Biosanitary Research of Granada (IBS), University of Granada, 18014 Granada, Spain.
Virgen de las Nieves University Hospital, 18014 Granada, Spain.
出版信息
Healthcare (Basel). 2023 Jan 26;11(3):353. doi: 10.3390/healthcare11030353.
BACKGROUND
Communication and advance care directives may be affected by the presence of dementia. We sought to describe the information and end-of-life preferences provided to nursing homes residents and their families.
METHODS
Trained nurses collected information from 124 residents randomly selected with palliative care needs from eight nursing homes.
RESULTS
A total of 54.4% of the residents with dementia had been provided with information about their state of health, compared to 92.5% of the residents without dementia ( < 0.01); family members exhibited no differences regarding information ( = 0.658), regardless of whether the resident was cognitively impaired. Most advance care interventions remained unexplored, except for cases where a transfer to hospital (81.5%) or serotherapy (69.4%) was desired. Decisions regarding palliative sedation ( = 0.017) and blood transfusion ( = 0.019) were lower among residents with dementia.
CONCLUSIONS
Residents, especially residents with dementia, are provided with limited information and their preferences are inadequately explored.
背景
沟通和预立医疗照护计划可能会受到痴呆症的影响。我们试图描述提供给养老院居民及其家属的信息以及临终偏好。
方法
经过培训的护士从八家养老院中随机挑选出124名有姑息治疗需求的居民，收集相关信息。
结果
共有54.4%的痴呆症居民了解了自己的健康状况，而无痴呆症居民的这一比例为92.5%（P<0.01）；无论居民是否存在认知障碍，家庭成员在信息了解方面均无差异（P = 0.658）。除希望转院（81.5%）或接受血清疗法（69.4%）的情况外，大多数预立医疗照护干预措施仍未得到探索。痴呆症居民中关于姑息性镇静（P = 0.017）和输血（P = 0.019）的决策较少。
结论
居民，尤其是痴呆症居民，获得的信息有限，其偏好也未得到充分探索。
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