艾滋病毒感染者的生命末期讨论和偏好
N S Wenger1, D E Kanouse, R L Collins
1University of California at Los Angeles Department of Medicine, GIM/HSR, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA. nwenger@mednet.ucla.edu
JAMA
|June 13, 2001
概括
一半的艾滋病毒成年人缺乏终身护理讨论,增加风险. 针对性干预对黑人,拉丁裔和受教育程度较低的艾滋病毒感染者至关重要,以改善预先的护理计划.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 艾滋病毒/艾滋病护理
背景情况:
- 预先的护理计划对于终身决策至关重要,但缺口让许多人没有准备.
- 尽管人类免疫缺陷病毒 (HIV) 感染的预后有所改善,但生命末期护理的规划仍然至关重要.
研究的目的:
- 评估艾滋病毒感染者中生命终结讨论和预先指令使用的普遍性.
- 探索患者人口统计,临床状况,心理社会因素和从业人员特征与终身护理规划之间的关系.
主要方法:
- 对美国231,400名接受HIV治疗的成年人进行了一项概率样本的横截面调查.
- 收集的数据包括关于生命终点问题的沟通,提前指令完成,护理侵略性偏好和对不良健康状况的容忍度.
主要成果:
- 50%的患者与他们的医生讨论了终身护理;38%完成了预先指令.
- 医生讨论显著增加了提前指令完成 (OR,5.82).
- 与黑人和拉丁裔患者的讨论较少,以及通过注射药物使用或教育程度较低的感染者.
结论:
- 很大一部分艾滋病毒感染者可能在没有事先与从业人员讨论的情况下面临生命终结的决定.
- 对于黑人,拉丁裔,注射毒品使用者以及艾滋病毒临床计划中受教育程度较低的人来说,急需预先计划护理的干预措施.
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