在患有严重疾病的成年人中,提前护理计划的激励因素
Sarah Nouri1, Carine Davila2,3, Stephanie H Chan4,5
1Division of Palliative Medicine, Department of Medicine, University of California San Francisco.
JAMA network open
|November 4, 2025
概括
提前护理计划 (ACP) 讨论与亲人是常见的,但与临床医生很少发生,即使是那些患有严重疾病的人. 对严重疾病护理的担忧与更高的非洲国家和地区参与相关.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 在患有严重疾病的人群中,预先护理计划 (ACP) 的参与尚未得到充分理解.
- 了解影响ACP的因素对于改善终身护理讨论和文档至关重要.
研究的目的:
- 确定是否有严重的疾病和与之相关的担忧与事先的护理计划的参与有关.
- 分析严重疾病与ACP之间的关联与亲密人士和临床医生的讨论,以及文档.
主要方法:
- 一项采用美国全国代表性调查 (2021年4月至5月) 的横截面研究.
- 来自1854名成年参与者的数据 (英语/西班牙语使用权重百分比,奇平方测试和多变量逻辑回归) 被分析.
- 关键的成果包括了ACP讨论 (与亲密的人,临床医生) 和书面文件,以及对严重疾病的障碍和担忧.
主要成果:
- 患有严重疾病的个人 (20%) 与没有 (62.6%) 相比,显示了更高的ACP参与率 (76.5%).
- 严重的疾病与与亲密的人 (aOR=1.57-1.66) 和临床医生 (aOR=2.16-2.22) 讨论ACP的可能性增加.
- 没有发现严重疾病和阿克巴国家/地区文档之间有重大关联;常见障碍包括不考虑它和假设代用知识.
结论:
- 虽然与亲人的讨论很普遍,但与临床医生的接触和文档仍然很低,即使是那些患有严重疾病的人.
- 与严重疾病护理相关的担忧 (例如,财务,代孕决策,治疗机会) 与阿克巴参与积极相关.
- 研究结果表明,将面向患者的ACP信息量身定制,以解决特定担忧,可能会提高参与度.
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