香港重症监护室的生命终结实践:来自Ethicus-2研究的结果
G M Joynt1, S K H Ling2, L L Chang3
1Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Hong Kong medical journal = Xianggang yi xue za zhi
|August 15, 2024
概括
生命终端护理,包括维持生命治疗 (LST) 的限制,在香港的重症监护病房 (ICU) 常见. 医生和家人之间共享决策,优先考虑患者.
科学领域:
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 终身护理是重症监护室 (ICU) 中经常发生的情况.
- 现有的终身护理指南并不总是反映在实际实践中.
- 需要了解香港重症监护室当前的终身护理实践.
研究的目的:
- 描述香港重症监护病房的终身护理实践.
- 分析维持生命治疗 (LST) 限制的流行率和模式.
- 确定终身护理的决策过程和主要考虑因素.
主要方法:
- 对Ethicus-2研究的一项前性,多中心的观测子分析.
- 在6个月内连续包括成年ICU患者的LST限制或死亡.
- 随访直到患者死亡或LST决定后2个月.
主要成果:
- 维持生命治疗 (LST) 的限制发生在11.1%的患者 (n=548),扣留 (77.6%) 比撤销 (22.4%) 更常见.
- 医生发起讨论 (86.2%),医生和家庭之间的共享决策是占主导地位的模式 (94.0%).
- 导致LST限制的主要原因包括对最大治疗 (49.2%) 和多器官衰竭 (17.1%) 的不响应,患者的最佳利益是主要考虑因素 (81.5%).
结论:
- 在香港的ICU中,维持生命治疗的限制很普遍.
- 涉及医生和家庭的共同决策,专注于患者的最佳利益是主要的方法.
- 鉴于经常失去决策能力,应鼓励患者通过预先指示或与代孕者沟通来表达终身偏好.
更多相关视频
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
20.2K
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
2.7K
相关概念视频
Ethical Issues
879
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
879
Ethical Dilemmas II
965
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
965
Nursing Ethical Principles II
936
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
936
Continuing Care
1.4K
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
1.4K
Standards of Care II
638
Nurses bear specific legal responsibilities under several federal statutes, including:
638
Ethical Dilemmas I
867
Ethical dilemmas in nursing are of utmost importance, as they often arise from the tension between adhering to core ethical principles and the practical realities of healthcare delivery. These dilemmas require nurses to navigate complex situations where competing ethical considerations pull them in different directions.
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
867
