国际专家如何定义预先护理规划:内容分析
Jenny T van der Steen1, Emma J de Wit2, Mandy Visser3
1Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Radboudumc Alzheimer Center and Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands; Cicely Saunders Institute, King's College London, London, UK.
Annals of palliative medicine
|September 23, 2024
概括
国际专家将预先护理计划 (ACP) 定义为以个人为中心的关于未来护理选择的对话. 这种广泛的定义强调了患者的价值观,而不是生命结束的具体情况或文档.
科学领域:
- 医学伦理 医学伦理
- 老年医学 老年医学
- 卫生沟通健康沟通
背景情况:
- 预先护理计划 (ACP) 已经转向探索广泛的患者价值观和偏好.
- 非洲和非洲国家/地区的国际实践多样化,需要明确,共享的理解.
- 定义ACP对于一致实施至关重要,特别是在痴呆症护理方面.
研究的目的:
- 探索国际专家如何定义预先护理计划 (ACP).
- 为了确定ACP的专家定义是否因医疗专业而异.
- 从全球的角度来看,从ACP定义中确定核心组成部分.
主要方法:
- 一项探索性研究使用了来自Delphi研究的基线数据.
- 来自30个国家的专家 (n=87) 提供了ACP.的单句定义.
- 内容分析被用来对定义元素进行分类,并评估措辞观点 (患者,专业,中立).
主要成果:
- 几乎一半的专家 (45%) 从患者的角度定义了ACP;29%是中立的,26%是专业的.
- 关键定义类别包括"选择选项"",护理和治疗"",计划未来"",个人"和"进行对话".
- 使用寿命末期和文档是不太频繁地提及的组成部分. 医生和其他医疗保健专业人员之间的定义没有显著差异.
结论:
- 国际专家通常将ACP概念化为以人为中心的对话,以未来的护理和治疗选择为重点.
- 专家的共识强调了广泛的价值观和偏好,而不仅仅是生命终端问题或文档.
- 未来的研究应该研究将这种概念化纳入临床实践和建议的整合.
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