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预先医疗指示:家庭内的信任故事。

Advance Care Planning: A Story of Trust Within the Family.

机构信息

Faculty of Business and Economics (HEC), University of Lausanne, Switzerland.

Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland.

出版信息

J Appl Gerontol. 2024 Apr;43(4):349-362. doi: 10.1177/07334648231214905. Epub 2023 Nov 20.

Abstract

As the family usually plays a central role at the end of life, the quality of family relationships may influence how individuals approach advance care planning (ACP). Our study investigates the associations of trust in relatives with regard to end-of-life (EOL) issues-used as a proxy measure of family relationship quality-with individuals' engagement in EOL discussions, advance directive (AD) awareness, approval and completion, and designation of a healthcare proxy. Using nationally representative data of adults aged 55 years and over from wave 6 (2015) of the Survey of Health, Ageing, and Retirement in Europe (SHARE) in Switzerland ( = 1911), we show that complete trust in relatives is related to higher engagement in ACP. Subject to patient consent, the family should, therefore, be included in the ACP process, as such practice could enhance patient-centered EOL care and quality of life at the end of life.

摘要

由于家庭通常在生命末期扮演核心角色,家庭关系的质量可能会影响个人对待预先医疗护理计划(ACP)的方式。我们的研究调查了对临终(EOL)问题的亲属信任程度(用作家庭关系质量的替代衡量标准)与个人参与 EOL 讨论、预先指示(AD)意识、批准和完成以及指定医疗保健代理人之间的关联。我们使用来自瑞士的欧洲健康、老龄化和退休调查(SHARE)第六波(2015 年)中 55 岁及以上成年人的全国代表性数据(n = 1911),表明对亲属的完全信任与更高的 ACP 参与度相关。在获得患者同意的前提下,应将家庭纳入 ACP 过程,因为这种做法可以增强以患者为中心的临终关怀和生命末期的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6211/10875907/7be05dd3f5c0/10.1177_07334648231214905-fig1.jpg

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