Featherstone Hannah Joan, McQuilllan Regina, Lombard John, Foley Geraldine
Palliative Medicine, St Francis Hospice Raheny, Dublin, Ireland
Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland.
BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2527-e2531. doi: 10.1136/spcare-2024-005065.
People receiving end-of-life care often require assistance with decision-making. We aimed to ascertain from the perspective of palliative care healthcare professionals in Ireland, the impact of the Assisted Decision-Making (Capacity) Act 2015 (as amended) in Ireland on their practice for end-of-life care decision-making with patients and family caregivers.
A qualitative study comprising focus groups was conducted with 22 healthcare professionals from different healthcare professions. Participants were recruited from a large regional specialist palliative care service in Ireland comprising two hospice sites. Data were analysed using thematic analysis.
Participants reported uncertainty about the Assisted Decision-Making (Capacity) Act 2015 (as amended) and emphasised a need for more public education to avoid misinterpretation of the Act. Participants felt that patients who need assistance with decision-making should be autonomous in decision-making but expressed concerns when patients made decisions about care that participants considered unwise. Participants considered that the Act would be beneficial in situations to support early communication between patients and their family caregivers about patient preferences for care.
Larger scale multicentre examination of the Assisted Decision-Making (Capacity) Act among specialist palliative care providers in Ireland is needed to better understand its utility for practice.
接受临终关怀的患者往往需要决策方面的协助。我们旨在从爱尔兰姑息治疗医护专业人员的角度，确定2015年《辅助决策（能力）法》（经修订）对他们在为患者及家庭护理人员进行临终关怀决策时的实践产生的影响。
对来自不同医疗行业的22名医护专业人员进行了一项包含焦点小组的定性研究。参与者从爱尔兰一个大型地区专科姑息治疗服务机构招募，该机构包括两个临终关怀场所。采用主题分析法对数据进行分析。
参与者表示对2015年《辅助决策（能力）法》（经修订）存在不确定性，并强调需要更多公众教育以避免对该法的误解。参与者认为，需要决策协助的患者在决策时应具有自主性，但当患者做出参与者认为不明智的护理决策时，他们表达了担忧。参与者认为该法在支持患者及其家庭护理人员就患者的护理偏好进行早期沟通的情况下会有所帮助。
需要在爱尔兰的专科姑息治疗提供者中对《辅助决策（能力）法》进行更大规模的多中心研究，以更好地了解其在实践中的效用。
