种族和对患者自主权的态度
L J Blackhall1, S T Murphy, G Frank
1Department of Medicine, Pacific Center for Health Policy and Ethics, University of Southern California, Los Angeles, USA.
JAMA
|September 13, 1995
概括
在终身护理偏好中观察到种族差异. 韩裔美国人和墨西哥裔美国人倾向于以家庭为中心的决策,与偏爱患者自主权的欧洲人和非洲裔美国人不同.
科学领域:
- 老年学是指老年学的学科.
- 社会学 社会学 社会学
- 医学伦理 医学伦理
背景情况:
- 文化态度显著影响终身护理偏好.
- 了解EOL决策中的种族差异对于文化敏感的医疗实践至关重要.
研究的目的:
- 调查种族群体对揭露绝症诊断和预后的态度的差异.
- 检查不同老年人群中EOL决策偏好的变化.
主要方法:
- 采用了一个调查研究设计.
- 数据收集来自800名老年人 (65岁以上) 的数据,来自四个种族:欧洲裔美国人,非洲裔美国人,韩裔美国人和墨西哥裔美国人.
- 参与者从洛杉矶县的老年人中心招募.
主要成果:
- 在癌症诊断和终端预后披露的态度中发现了显著的种族差异.
- 与欧洲人和非洲裔美国人相比,韩裔美国人和墨西哥裔美国人不太可能相信患者应该被告知诊断/预后.
- 韩裔美国人和墨西哥裔美国人更喜欢以家庭为中心的生命支持决策,与欧洲人和非洲裔美国人的患者自主权偏好形成鲜明对比. 种族已经成为主要的预测因素.
结论:
- 高龄的韩裔美国人和墨西哥裔美国人主要支持以家庭为中心的医疗决策模式.
- 欧洲裔美国人和非洲裔美国老年受试者在很大程度上更喜欢患者自主模型.
- 医生应该询问患者对信息披露和决策参与的偏好,或者是否希望家庭参与.
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