一项横截面研究评估在农村卫生区预先护理指令的一致性
Dan Curley1, Leigh Kinsman2, Graeme Mooney1
1Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia.
The Australian journal of rural health
|August 10, 2024
概括
澳大利亚农村地区对预先护理指令 (ACD) 的遵守率很高,特别是在不可接受的干预方面. 虽然家庭是许多人最喜欢的死亡地点,但在这些情况下,遵守是最低的.
科学领域:
- 医学伦理 医学伦理
- 抚慰性护理是一种缓解性护理.
- 农村卫生 农村卫生
背景情况:
- 预先护理指令 (ACD) 对于确保患者在终身护理中的自主性至关重要.
- 根据地理位置和医疗保健系统因素,遵守ACDs可能会有很大差异.
- 农村环境对实施终身护理偏好提出了独特的挑战和考虑.
研究的目的:
- 评估澳大利亚农村环境中已故个人遵守预先护理指令 (ACD).
- 将ACD中记录的偏好与实际结果进行比较,重点关注死亡地点和接受干预措施.
- 确定农村人口中ACD遵守的任何差异.
主要方法:
- 通过医疗记录审计进行了一项观察性,横截面研究.
- 这项研究包括68名来自澳大利亚农村沿海地区的死者,他们患有ACD并参加了当地研究项目.
- 通过将ACD请求 (死亡地点,不可接受的干预) 与医疗记录结果进行比较来评估合规性.
主要成果:
- 总体而言,对ACD的遵守很强,特别是在拒绝"不可接受的干预措施"方面 (100%的遵守).
- 遵守首选死亡地点的情况有所不同:整体63%,家庭为48%,次急性护理为78%,医院为100%.
- 在研究参与者 (平均年龄67岁) 中,癌症是主要的死亡原因 (71%).
结论:
- 这项研究强调了澳大利亚农村地区对预先护理指令的坚定遵守,特别是在维持生命的治疗方面.
- 虽然家庭死亡是最常见的偏好,但与医院或亚急性环境相比,合规率较低.
- 需要进一步的研究,以了解和改进农村终身护理中对首选死亡地点的遵守.
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