养老院居民的管饲偏好。
Tube feeding preferences among nursing home residents.
作者信息
O'Brien L A, Siegert E A, Grisso J A, Maislin G M, LaPann K, Evans L K, Krotki K P
机构信息
Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, USA.
出版信息
J Gen Intern Med. 1997 Jun;12(6):364-71. doi: 10.1046/j.1525-1497.1997.00061.x.
OBJECTIVE
To determine the preferences of nursing home residents regarding the use of tube feedings and to characterize the clinical, functional, and psychosocial factors that are associated with preferences.
DESIGN
In-person survey.
SETTING
Forty-nine randomly selected nursing homes.
PATIENTS/PARTICIPANTS: Three hundred seventy-nine randomly selected, decisionally capable, nursing home residents.
MAIN RESULTS
Thirty-three percent of participants would prefer tube feedings if no longer able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender. African-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advance directive, and believing that tube feeding preferences will be respected by the nursing home staff. Twenty-five percent of the participants changed from preferring tube feedings to not preferring tube feedings on learning that physical restraints are sometimes applied during the tube feeding process.
CONCLUSIONS
Demographic and social factors are associated with preferences for tube feedings. The provision of information about the potential use of physical restraint altered a proportion of nursing home residents' treatment preferences.
目的
确定疗养院居民对使用管饲的偏好，并描述与这些偏好相关的临床、功能和心理社会因素。
设计
面对面调查。
地点
随机选择的49家疗养院。
患者/参与者：随机选择的379名有决策能力的疗养院居民。
主要结果
33%的参与者表示，如果因永久性脑损伤而无法进食，他们更倾向于管饲。与管饲偏好呈正相关的因素包括男性、非裔美国人、从未与家庭成员或医疗服务提供者讨论过治疗偏好、从未签署过预先指示，以及相信疗养院工作人员会尊重管饲偏好。25%的参与者在得知管饲过程中有时会使用身体约束后，从倾向于管饲转变为不倾向于管饲。
结论
人口统计学和社会因素与管饲偏好有关。提供有关可能使用身体约束的信息改变了一部分疗养院居民的治疗偏好。
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