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年轻人在接受麻醉前会完成医疗代理委托书吗?

Do young adults complete health care proxies before anesthesia?

作者信息

Spence Matthew C, Serra Theresa, Gross Elissa

机构信息

Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA.

Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.

出版信息

Health Care Transit. 2023 Oct 30;1:100025. doi: 10.1016/j.hctj.2023.100025. eCollection 2023.

Abstract

BACKGROUND

Health care proxy (HCP) completion rates by older adults are relatively low; however, not much is known about proxy completion rates by younger adults.

OBJECTIVES

This study aimed to identify HCP completion rates amongst 18-21 year old young adults without intellectual disabilities admitted to a pediatric hospital peri-anesthesia care unit (PACU) and determine whether there was an association with any demographic factors.

METHODS

Retrospective chart review was performed to describe demographic variables, presence of HCP, and relationship to proxy. The relationship between demographic groups and HCP completion was analyzed by chi-square analysis for categorical variables and student t-test for continuous variables.

RESULTS

Overall, 31.4 % (128/408) of patients completed an HCP, and younger patients were more likely to have done so. Analysis showed no statistically significant relationship between other demographic variables and HCP completion. A majority of patients identified a parent as their proxy.

CONCLUSION

Less than one third of young adult patients admitted to a children's hospital perioperative care unit completed a health care proxy. Other than age, there was no statistically significant difference in demographic variables between those who completed and did not complete a health care proxy. Further research is needed to validate these findings in other clinical settings and drive targeted initiatives to increase advance care planning among young adult patients.

摘要

背景

老年人完成医疗保健代理人(HCP)的比例相对较低;然而,对于年轻人完成代理人的比例了解不多。

目的

本研究旨在确定入住儿科医院围麻醉护理单元(PACU)的18至21岁无智力障碍的年轻人中HCP的完成率,并确定其是否与任何人口统计学因素相关。

方法

进行回顾性病历审查,以描述人口统计学变量、HCP的存在情况以及与代理人的关系。对于分类变量,采用卡方分析;对于连续变量,采用学生t检验,分析人口统计学组与HCP完成情况之间的关系。

结果

总体而言,31.4%(128/408)的患者完成了HCP,年轻患者更有可能完成。分析表明,其他人口统计学变量与HCP完成情况之间无统计学显著关系。大多数患者指定父母为其代理人。

结论

入住儿童医院围手术期护理单元的年轻成年患者中,不到三分之一完成了医疗保健代理人的指定。除年龄外,完成和未完成医疗保健代理人指定的患者在人口统计学变量上无统计学显著差异。需要进一步研究以在其他临床环境中验证这些发现,并推动有针对性的举措,以增加年轻成年患者的预先护理计划。

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