高度心力衰竭的提前护理规划:个体自治的幻觉
Tieghan Killackey1,2, Elizabeth Peter1, Jane Maciver1,2
1Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Qualitative health research
|September 30, 2025
概括
对心力衰竭患者的预先护理计划未得到充分利用. 在这个过程中,自治是由关系和权力动态所塑造的,而不仅仅是个人的选择.
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.
- 心脏病学 心脏病学
背景情况:
- 提前护理计划 (ACP) 对于将严重疾病的治疗与患者的价值观和偏好保持一致至关重要.
- 尽管ACP对于保持晚期心力衰竭 (AHF) 患者的自主性至关重要,但仍未得到充分利用.
- 在AHF中不断增长的治疗选择需要有效的ACP来确保以患者为中心的护理.
研究的目的:
- 探索AHF患者如何理解和表达在ACP进程中的自主权.
- 确定影响在ACP期间为晚期心力衰竭患者颁布自主权的因素.
主要方法:
- 采用了关键的定性多个案例研究方法.
- 从19次采访中收集了数据,采访了两个机构的AHF患者,护理人员和医疗保健提供者.
- 分析利用了基于女权主义伦理的自主关系概念.
主要成果:
- 在当前的生物医学模型中,ACP通常被认为与核心治疗决策分开.
- 在AHF中,自治的经验往往与主流的个人主义观点相矛盾.
- 人际关系,责任和权力动态极大地影响了非洲和非洲国家.
结论:
- 虽然ACP旨在维护个人自主权,但其实践在很大程度上受到人际,机构和社会关系的影响.
- 一个关系框架对于理解非洲和美洲的自治是必不可少的,承认其嵌入在社会和制度背景.
- 未来的研究应该通过采用关系视角来推进ACP,以更好地支持高级心力衰竭护理中的患者自主权.
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