Hui E, Ho S C, Tsang J, Lee S H, Woo J
Medical and Geriatric Unit, Shatin Hospital, N.T., Hong Kong.
J Am Geriatr Soc. 1997 Oct;45(10):1232-6. doi: 10.1111/j.1532-5415.1997.tb03776.x.
There have been few studies of the attitudes of older Asians toward life-sustaining therapy. This paper presents the knowledge of and attitudes toward cardiopulmonary resuscitation (CPR) and life support in a group of subjects in Hong Kong.
Cross-sectional, descriptive study.
Of the 543 subjects, 382 were old-age home residents and 161 were in-patients of geriatric wards.
Sociodemographic data, functional ability (using the Barthel Index), self-perceived health scale, knowledge of life-sustaining procedures, and subjects' preferences for such treatments were studied. They were also asked to give the most important reason for wanting or declining CPR, and to indicate who they believe should be the decision-maker(s) regarding whether they should receive life-sustaining treatment.
Approximately 80% of old-age home residents and 60% of hospitalized patients had no knowledge of life-sustaining therapy. The success rate of CPR was overestimated by older subjects, and most wished to be resuscitated. However, up to 20% changed their minds and declined CPR after they knew the true outcome of the procedure. Half of the subjects wanted life support. Univariate analysis found that advanced age and not having a spouse were associated significantly with CPR preference, whereas subjects' knowledge was associated with preference for life support. Multivariate analysis revealed that advanced age, not having a spouse, and female sex were independently associated with a tendency to decline CPR. A considerable proportion of older people wished to be involved in decision-making regarding life-sustaining treatment.
Knowledge of life-sustaining procedures was poor among older people in Hong Kong compared with their counterparts in western countries. Although most older subjects wanted CPR, a number of them changed their minds after they knew the poor outcome. Therefore, older patients should be given more information about life-sustaining therapy and encouraged to take part in their treatment plans.
关于亚洲老年人对维持生命治疗的态度，相关研究较少。本文呈现了香港一组受试者对心肺复苏（CPR）及生命支持的认知与态度。
横断面描述性研究。
543名受试者中，382名是养老院居民，161名是老年病房的住院患者。
研究社会人口统计学数据、功能能力（使用巴氏指数）、自我感知健康量表、维持生命程序的知识以及受试者对这类治疗的偏好。还询问了他们希望或拒绝心肺复苏的最重要原因，并指出他们认为在是否接受维持生命治疗方面应由谁来做决定。
约80%的养老院居民和60%的住院患者对维持生命治疗一无所知。老年受试者高估了心肺复苏的成功率，且大多数希望被复苏。然而，高达20%的人在了解该程序的真实结果后改变主意并拒绝心肺复苏。一半的受试者希望接受生命支持。单因素分析发现，高龄和没有配偶与心肺复苏偏好显著相关，而受试者的知识与生命支持偏好相关。多因素分析显示，高龄、没有配偶和女性性别独立与拒绝心肺复苏的倾向相关。相当一部分老年人希望参与维持生命治疗的决策。
与西方国家的老年人相比，香港老年人对维持生命程序的了解较差。尽管大多数老年受试者希望进行心肺复苏，但他们中的一些人在了解到糟糕的结果后改变了主意。因此，应该向老年患者提供更多关于维持生命治疗的信息，并鼓励他们参与自己的治疗计划。
