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德国记忆诊所中的预先指示。

Advance directives in German memory clinics.

作者信息

Garmann Daniel, Abele Christina, Baisch Stefanie, Karneboge Jonas, Lindl Gregor, Florack Janina, Theile-Schürholz Anna, Haberstroh Julia

机构信息

Department of Psychology, Psychological Aging Research, University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany.

Klinikum Siegen, Siegen, Germany.

出版信息

Z Gerontol Geriatr. 2025 Jun 27. doi: 10.1007/s00391-025-02455-z.

Abstract

People have the right to accept or refuse medical treatment provided they give voluntary, prior and informed consent. When capacity to consent is impaired, autonomy can be preserved through a clear, legally valid advance directive. Cognitive impairments, such as dementia, increase the risk of compromised capacity to consent. This study examines the prevalence of advance directives among patients at German memory clinics and explores predictors influencing their presence, focusing on compliance with informed consent standards.Using an observational cross-sectional design, 289 outpatients were assessed. Data included the presence of advance directives, circumstances of their creation and the patient characteristics age, gender, education, cognitive status, physical and mental health, need for autonomy in medical decision-making and health literacy. Descriptive statistics were calculated, and multivariable logistic regression models were applied to analyze the data.The results indicate that age is the strongest predictor for the presence of advance directives. Beyond age, specific events or experiences, rather than personal traits, may prompt individuals to create advance directives.

摘要

人们有权接受或拒绝医疗治疗,前提是他们给予自愿、事先和知情同意。当同意能力受损时,可以通过明确、具有法律效力的预先指示来维护自主权。认知障碍,如痴呆症,会增加同意能力受损的风险。本研究调查了德国记忆诊所患者中预先指示的患病率,并探讨影响其存在的预测因素,重点关注对知情同意标准的遵守情况。采用观察性横断面设计,对289名门诊患者进行了评估。数据包括预先指示的存在情况、其制定的情况以及患者的特征,如年龄、性别、教育程度、认知状态、身心健康、医疗决策中的自主需求和健康素养。计算了描述性统计数据,并应用多变量逻辑回归模型分析数据。结果表明,年龄是预先指示存在的最强预测因素。除年龄外,特定的事件或经历,而非个人特质,可能促使个人制定预先指示。

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