Perry L D, Nicholas D, Molzahn A E, Dossetor J B
ANNA J. 1995 Oct;22(5):457-63, 481; discussion 464.
The objective of this study was to describe and compare the attitudes of dialysis patients, their relatives/friends, primary nephrologists, and nurses regarding advance directives.
A descriptive comparative design was used.
SAMPLE/SETTING: A total of 50 dialysis patients from a large teaching hospital in western Canada participated in the study. For every patient who responded, a relative/friend, physician, and nurse completed the questionnaire.
The questionnaires were designed for the purposes of the study. These questionnaires were mailed to dialysis patients, who were asked to identify a relative/friend to complete a similar questionnaire. Nurses and physicians also completed questionnaires.
Overall, 84% of patients indicated that they believed that it was important to leave a living will, but only 18% of these patients had actually left an advance directive. However, 52% of patients and relatives/friends believed that major treatment decisions should be left to the physician, a perception that was not shared by physicians and nurses.
It appears that patients, family/friends, nurses, and physicians in this study had differing perceptions regarding advance directives. It is important that health care professionals realize that these differences may exist and that further research should address strategies to increase our understanding of patient decisions in this area.
本研究的目的是描述和比较透析患者、其亲属/朋友、初级肾病专家和护士对预先指示的态度。
采用描述性比较设计。
样本/环境：来自加拿大西部一家大型教学医院的50名透析患者参与了该研究。对于每一位做出回应的患者，一名亲属/朋友、医生和护士完成了问卷。
问卷是为该研究目的而设计的。这些问卷被邮寄给透析患者，要求他们指定一名亲属/朋友完成一份类似的问卷。护士和医生也完成了问卷。
总体而言，84%的患者表示他们认为留下一份生前遗嘱很重要，但这些患者中只有18%实际留下了预先指示。然而，52%的患者及其亲属/朋友认为重大治疗决策应由医生做出，而医生和护士并不认同这一观点。
本研究中的患者、家属/朋友、护士和医生似乎对预先指示有不同的看法。医疗保健专业人员必须认识到这些差异可能存在，并且进一步的研究应探讨策略，以增进我们对该领域患者决策的理解。
