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加纳科福阿訇教学医院慢性肾脏病患者对开展预先医疗照护计划准备情况的看法。

Perspectives of Chronic Kidney Disease Patients on Readiness for Advance Care Planning at Komfo Anokye Teaching Hospital, Ghana.

机构信息

Family Medicine Department, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.

Faculty of Palliative Care, Ghana College of Nurses and Midwives, Accra, Ghana.

出版信息

Yale J Biol Med. 2024 Jun 28;97(2):115-124. doi: 10.59249/NZCS6192. eCollection 2024 Jun.

Abstract

This study examined the impact of advance care planning (ACP) on the quality of life for patients with chronic kidney disease (CKD) at Komfo Anokye Teaching Hospital in Ghana. It specifically investigated patients' perspectives on their readiness for ACP. Utilizing a qualitative descriptive design, one-on-one interviews were conducted with CKD patients at the renal clinic, employing a semi-structured interview guide for thematic analysis of audio data. The findings revealed a gap in understanding among CKD patients, with participants acknowledging their vulnerability to renal failure, often linked to a medical history of diabetes and hypertension. Despite recognizing potential outcomes such as dialysis dependency or death, some patients retained hope for a cure, relying on faith. The initial kidney failure diagnosis induced shock and distress, leading many patients to prefer the comfort and familiarity of home-based care, including dialysis. Meanwhile, a minority favored hospital care to protect their children from psychological trauma. Most patients deemed legal preparations unnecessary, citing limited assets or a lack of concern for posthumous estate execution. These insights emphasize the necessity for targeted education and support in ACP to enhance patient outcomes in chronic kidney disease care and end-of-life planning.

摘要

这项研究考察了预先医疗护理计划(ACP)对加纳科福·阿诺克耶教学医院慢性肾脏病(CKD)患者生活质量的影响。它特别调查了患者对其准备接受 ACP 的看法。本研究采用定性描述性设计,在肾脏科对 CKD 患者进行了一对一的访谈,使用半结构化访谈指南对音频数据进行主题分析。研究结果显示,CKD 患者存在理解上的差距,参与者承认自己易患肾衰竭,这通常与糖尿病和高血压的病史有关。尽管患者认识到潜在的结果,如依赖透析或死亡,但一些患者仍抱有治愈的希望,依赖于信仰。最初的肾衰竭诊断带来了震惊和痛苦,导致许多患者更愿意在家中接受舒适和熟悉的护理,包括透析。另一方面,少数人则倾向于在医院接受治疗,以保护他们的孩子免受心理创伤。大多数患者认为法律准备是不必要的,理由是资产有限或对身后遗产执行不关心。这些观点强调了在 ACP 中进行有针对性的教育和支持的必要性,以改善慢性肾脏病护理和临终规划中的患者结局。

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The major global burden of chronic kidney disease.慢性肾脏病的主要全球负担。
Lancet Glob Health. 2024 Mar;12(3):e342-e343. doi: 10.1016/S2214-109X(24)00050-0.

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