在儿科重症监护病房 (Pediatric Intensive Care Unit) 参与终身决策的基于价值的因素
Gwendolyn J Richner1,2,3, Daniel H Grossoehme1,2,4, Sarah Friebert1,5
1Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, Ohio, USA.
Journal of palliative medicine
|October 29, 2025
概括
家庭经常拒绝在儿科重症监护室 (PICU) 的儿童进行心肺复苏 (CPR). 心理,社会,精神和道德价值观对这些生命终结决定产生重大影响.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 生物伦理学生物伦理学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 超过80%的家庭在孩子死亡后的24小时内放弃了在PICU的终身治疗.
- 影响这些生命终结决策的因素尚不清楚.
- 了解基于价值的因素对于支持家庭至关重要.
研究的目的:
- 在儿童拒绝心肺复苏 (CPR) 时探索家庭决策.
- 使用整体价值观和道德原则的框架.
- 将PICU中的终身护理选择置于背景中.
主要方法:
- 从电子病历中获得的混合方法数据的定性分析.
- 从PICU和儿科息治疗 (PPC) 笔记中对叙事文档进行主题分析.
- 涉及19个有目的地选择的儿童及其家庭/提供者在美国中西部四级儿科医院.
主要成果:
- 确定了影响决策的关键主题:家庭支持,个人价值观,精神信仰,道德标准和沟通/语言.
- 医疗提供者使用的语言和术语是重要的因素.
- 家庭支持系统和个人/精神信仰发挥了关键作用.
结论:
- 心理社会,伦理和精神因素显著影响决定放弃像CPR这样的高强度护理.
- 提供者在指导家庭时应该考虑这些基于价值的因素.
- 咨询PPC,患者倡导和伦理团队可以帮助决策.
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