Macedo João Carlos, Macedo Ermelinda, Nunes Rui
Nursing School, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Av. Bissaya Barreto, 3046-851 Coimbra, Portugal.
Healthcare (Basel). 2024 Jan 13;12(2):195. doi: 10.3390/healthcare12020195.
(1) Background: Advance directives (ADs) in Portugal have been legalized since 2012. What has been observed over time, from the few studies carried out, is that despite the positive attitudes in the population, there is a low level of adherence to ADs. To try to understand the reasons for these data, the current study aimed to explore and describe the experiences of the Portuguese population regarding AD. (2) Methods: For this exploratory and descriptive qualitative study, the researchers conducted open (unstructured) interviews with a convenience sample aged over 18 years until data saturation was achieved. (3) Results: A total of fifteen interviews were conducted-eight with women and seven with men. The following four categories emerged from the content analysis of the interviews: (1) AD literacy, (2) AD relevance, (3) AD attitudes, and (4) conditionalities for compiling the ADs. (4) Conclusions: The study pointed out the good receptivity of the participants to the ADs; however, literacy on this subject was low, and identifying the conditionalities in the development of ADs could contribute to improvements in implementation in the population. The data from this study suggest the need to implement measures to increase the literacy of the Portuguese population on ADs and review the legal framework for improving the accessibility of the citizen population. There is also a need to continue researching and obtain more evidence about the ways in which the Portuguese population perceives ADs; thus, in this way, a society can better respond to its citizens' right to freely exercise their prospective autonomy at the end of their lives.
(1) 背景:自2012年起,葡萄牙的预先医疗指示(ADs)已合法化。从已开展的少数研究中可以观察到,随着时间推移,尽管民众持积极态度,但对预先医疗指示的依从性较低。为了试图理解这些数据背后的原因,本研究旨在探索并描述葡萄牙民众对预先医疗指示的体验。(2) 方法:对于这项探索性和描述性的定性研究,研究人员对18岁以上的便利样本进行了开放式(无结构)访谈,直至达到数据饱和。(3) 结果:共进行了15次访谈,其中8次访谈对象为女性,7次访谈对象为男性。访谈内容分析得出以下四类:(1) 预先医疗指示知识水平,(2) 预先医疗指示的相关性,(3) 对预先医疗指示的态度,以及(4) 编制预先医疗指示的条件。(4) 结论:该研究指出参与者对预先医疗指示具有良好的接受度;然而,这方面的知识水平较低,明确预先医疗指示制定过程中的条件可能有助于提高其在民众中的实施效果。本研究数据表明,有必要采取措施提高葡萄牙民众对预先医疗指示的知识水平,并审查法律框架以提高公民获取相关信息的便利性。此外,还需要继续开展研究并获取更多关于葡萄牙民众如何看待预先医疗指示的证据;这样,社会才能更好地回应公民在生命末期自由行使其预期自主权的权利。