卫生专业人员的特征与尊重癌症终末期患者自主权之间的关系。
Relationship between characteristics of health professionals and the respect for the autonomy of cancer patients at the end of life.
机构信息
Palliative nurse on Hospital Samaritano, São Paulo, Brazil.
Research and Teaching Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
出版信息
PLoS One. 2024 Nov 12;19(11):e0313513. doi: 10.1371/journal.pone.0313513. eCollection 2024.
BACKGROUND AND AIM
This study investigated whether providers respected patient's autonomy, investigating providers' pattern of decisions and their associated characteristics.
METHODS
Cross-sectional study, conducted through anonymous questionnaire with hypothetical clinical cases, presented to providers at one oncology center. Decision-making patterns were pre-stablished accordingly to the response´s pattern.
FINDINGS
Of 151 responses, decisions patterns were paternalistic in 38%, shared in 38%, obstinate in 10.6% and consumerist in 13.2%. The consumerist providers reported never having participated in an EOL class in 35% and 30% had never trained in palliative care. Among providers with paternalistic pattern, 35.1% had never attended ethic lectures. In the obstinate group, 31.2% had no training in palliative care. When asked how subjects saw themselves about their pattern of decision, 100% of obstinate, 95% of consumerist and 89% of paternalistic patterns exhibited cognitive dissonance.
CONCLUSION
Significative differences between decisions and how the providers judge themselves were observed.
背景与目的
本研究旨在调查医护人员是否尊重患者自主权，考察医护人员的决策模式及其相关特征。
方法
采用横断面研究方法，通过匿名问卷和肿瘤中心的临床案例，对医护人员进行调查。决策模式根据回答模式预先确定。
结果
在 151 份答卷中，决策模式分别为家长式 38%、协商式 38%、固执型 10.6%和消费者导向型 13.2%。消费者导向型医护人员中，35%的人从未参加过 EOL 课程，30%的人从未接受过姑息治疗培训。在家长式决策模式的医护人员中，35.1%的人从未参加过伦理讲座。在固执型决策模式的医护人员中，31.2%的人没有接受过姑息治疗培训。当被问及如何看待自己的决策模式时，固执型、消费者导向型和家长式决策模式的医护人员中，分别有 100%、95%和 89%的人表现出认知失调。
结论
研究观察到决策与医护人员自我评价之间存在显著差异。
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