提前护理计划影响心力衰竭患者终身治疗偏好:一项随机对照试验
概括
预先的护理规划干预措施显著减少了心力衰竭患者生命末期的医疗治疗. 这种方法可能有利于那些不熟悉讨论生命终端护理的人群.
科学领域:
- 心脏病学 心脏病学
- 医学伦理 医学伦理
- 健康心理学 心理健康心理学
背景情况:
- 提前护理规划 (ACP) 对于将终身护理与患者价值观保持一致至关重要.
- 心力衰竭 (HF) 患者经常面临复杂的EOL治疗决策.
- 需要有效的ACP干预,以支持高频率的知情决策.
研究的目的:
- 评估结构化ACP干预对住院HF患者EOL治疗偏好的影响.
- 确定干预是否会影响有关生命支持和其他医疗治疗的决定.
主要方法:
- 随机对照试验,包括82名住院HF患者.
- 干预小组收到了一个激励视频,教育小册子和指导讨论.
- 对照组接受了例行护理;生命支持偏好调查问卷用于前后评估.
主要成果:
- 在ACP干预组中,总体,抗生素,心肺复苏,手术和人工营养/补水的偏好在前后显著下降.
- 对照组在治疗偏好方面没有显著变化.
- 干预后,观察到群体之间的平均得分变化有显著差异,有利于干预组中选择的治疗方法较少.
结论:
- 一个多元件的ACP干预措施有效地减少了HF患者中医疗治疗的选择.
- 这种干预对那些不熟悉或不舒服地讨论ACP和EOL护理的人群来说可能是有益的.
- 非洲国家和地区的干预措施可以使患者能够根据他们的偏好做出符合EOL治疗决策.
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