亲人的死亡和预先护理计划:年龄的温和效应
Peiyuan Zhang1, Sarah Clem1, Roderick Rose1
1University of Maryland School of Social Work, Baltimore, MD, USA.
The American journal of hospice & palliative care
|July 5, 2023
概括
经历亲人的死亡增加了参与预先护理计划 (ACP) 的可能性,特别是与家人就终身护理偏好进行非正式讨论. 这种效应在年轻人与医生的对话中更为明显.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 提前护理计划 (ACP) 尽管有好处,但在美国仍未得到充分利用.
- 了解影响ACP参与的因素对于改善终身护理至关重要.
- 个人对死亡的经历可能会影响个人积极的生命结束计划.
研究的目的:
- 调查亲人死亡暴露与个人自身的ACP行为之间的关联.
- 检查年龄在死亡暴露和ACP之间的关系中所起的调节作用.
- 确定在美国人口中推广ACP的潜在策略.
主要方法:
- 全国1006名美国成年人的横截面调查.
- 概率抽样权重用于代表性.
- 二元逻辑回归和调节分析,以评估死亡暴露,年龄和ACP指标之间的关系 (与家庭/医生对话,预先指示).
主要成果:
- 对亲人死亡的接触与与家人进行非正式对话的几率增加了两倍 (OR = 2.03,P < .001).
- 年龄调节了死亡暴露和与医生进行的ACP对话之间的联系 (OR = 0.98,P = .017).
- 死亡暴露对与医生讨论的积极影响,与老年人相比,对于年轻人来说更为强烈.
结论:
- 经历过亲人的死亡的经历可以成为启动所有年龄段的ACP讨论的催化剂.
- 利用个人悲伤经历可能是一个有价值的策略,以鼓励非洲国家和地区的参与.
- 可能需要有针对性的方法来促进与医疗保健提供者进行终身护理讨论,特别是对年轻人来说.
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