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与痴呆症患者家庭照顾者完成预先医疗指示意愿相关的因素:一项横断面描述性研究。

Factors Associated with Family Caregivers' Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study.

作者信息

Park Hyeseon, Kang Sujin, Kim Youngji

机构信息

Intensive Care Unit, Yuseong Sun Hospital, Daejeon 34084, Republic of Korea.

Department of Nursing, The Catholic University of Korea, Seoul 06591, Republic of Korea.

出版信息

Healthcare (Basel). 2025 May 29;13(11):1297. doi: 10.3390/healthcare13111297.

Abstract

As dementia progresses, patients often lose decision-making capacity, leaving family members responsible for making critical end-of-life (EOL) care decisions. This cross-sectional descriptive study explored the factors associated with the intention to complete an advance directive (AD) among family caregivers of older adults with dementia in South Korea. : This study surveyed 140 caregivers aged 20 years or older to assess their knowledge of advance directives (ADs), preferences for EOL care, and attitudes toward withdrawing life-sustaining treatment (LST). Data were collected from 1 August to 14 August 2024, and analyzed using descriptive statistics, the Chi-squared test, Fisher's exact test, Spearman's correlation, and logistic regression, with SPSS/WIN 28.0. : The intention to complete an AD significantly differed by religion ( = 0.004) and the functional status of the patient with dementia ( = 0.012). There was a positive correlation between intention to complete an AD and knowledge of ADs (r = 0.23, = 0.007). Factors associated with intention to complete an AD included religion (OR = 4.36, = 0.028) and knowledge of ADs (OR = 1.16, = 0.033), explaining 22.2% of the variance, which is considered meaningful in studies dealing with complex psychosocial and behavioral variables. : These findings suggest that religious affiliation and knowledge of ADs may contribute to greater emphasis on EOL preparedness and self-determination. To promote informed decision making, it is essential to implement targeted educational interventions-such as community-based workshops, telehealth counseling, and in-clinic guidance-that enhance caregivers' understanding of ADs and empower them in their caregiving roles.

摘要

随着痴呆症的进展,患者往往会丧失决策能力,这使得家庭成员负责做出关键的临终(EOL)护理决策。这项横断面描述性研究探讨了韩国老年痴呆症患者家庭照顾者中与完成预立医疗指示(AD)意愿相关的因素。:本研究对140名20岁及以上的照顾者进行了调查,以评估他们对预立医疗指示的了解、对临终护理的偏好以及对撤除维持生命治疗(LST)的态度。数据于2024年8月1日至8月14日收集,并使用描述性统计、卡方检验、费舍尔精确检验、斯皮尔曼相关性分析和逻辑回归进行分析,使用的软件为SPSS/WIN 28.0。:完成预立医疗指示的意愿在宗教信仰方面(=0.004)和痴呆症患者的功能状态方面(=0.012)存在显著差异。完成预立医疗指示的意愿与对预立医疗指示的了解之间存在正相关(r = 0.23,=0.007)。与完成预立医疗指示意愿相关的因素包括宗教信仰(OR = 4.36,=0.028)和对预立医疗指示的了解(OR = 1.16,=0.033),这两个因素解释了22.2%的方差变异,在处理复杂的社会心理和行为变量的研究中被认为是有意义的。:这些发现表明,宗教信仰和对预立医疗指示的了解可能有助于更加强调临终准备和自我决定权。为了促进明智的决策,实施有针对性的教育干预措施至关重要,例如基于社区的工作坊、远程医疗咨询和临床指导,这些措施可以增强照顾者对预立医疗指示的理解,并使他们在照顾角色中更有能力。

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