Zhang Rong-Rong, Xu Yan, Zhao Yue-Ping
Department of Nursing, Faculty of International Medical Technology, Sanda University, Shanghai, China.
Int J Nurs Sci. 2022 Dec 29;10(1):46-52. doi: 10.1016/j.ijnss.2022.12.018. eCollection 2023 Jan.
This study aimed to explore the perception on advanced directives (ADs) among older adults in Shanghai.
Through purposive sampling, 15 older adults with rich life experiences who were willing to share perceptions and experiences of ADs participated in this study. Face-to-face semi-structured interviews were conducted to collect the qualitative data. Thematic content analysis was applied to analyze the data.
Five themes have been identified: low awareness but high acceptance of ADs; pursuing natural and peaceful sunset life; ambiguous attitude on medical autonomy; being irrational facing patients' dying and death issues; positive about implementing ADs in China.
It is possible and feasible to implement ADs in older adults. Death education and compromised medical autonomy may be needed in the Chinese context as the foundation. The elder's understanding, willingness and worries about ADs should be fully revealed. Diverse approaches should be applied to introduce and interpret ADs to older adults continuously.
本研究旨在探讨上海老年人对预立医疗照护计划(ADs)的认知情况。
通过目的抽样法,选取15名有丰富生活经历且愿意分享预立医疗照护计划认知和经历的老年人参与本研究。采用面对面半结构式访谈收集定性数据,并运用主题内容分析法对数据进行分析。
确定了五个主题:对预立医疗照护计划认知度低但接受度高;追求自然平和的晚年生活;对医疗自主权态度模糊;面对患者的濒死和死亡问题不理智;对在中国实施预立医疗照护计划持积极态度。
在老年人中实施预立医疗照护计划是可能且可行的。在中国背景下,可能需要以死亡教育和有限的医疗自主权作为基础。应充分了解老年人对预立医疗照护计划的理解、意愿和担忧,并采用多种方式持续向老年人介绍和解读预立医疗照护计划。