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作者

Ma, Wei Xue, Qingyun

作者单位

Shandong Academy of Medical Sciences, Tai'an, 271000, China Shandong First Medical University & The Second Affiliated Hospital of Shandong First Medical University & Graduate School of University of Chinese Academy of Social Sciences, Beijing, 102488, China Shandong Academy of Medical Sciences, Tai'an, 271016, China

刊名

Chinese General Practice

年份

2020

卷号

Vol.23 No.31

页码

3935

ISSN

1007-9572

摘要

Background: Nowadays, increasing attention has been paid on 'dignified death' and quality of life at the end of life. Instead of simply extending the length of life, hospice care patients with decision-making abilities begin to seek ways to make advance directives. As important participants in the process of making AD of patients, physicians and nurses' awareness of AD is directly associated with the promotion effect of AD. Objective: To explore the feasibility and practical path of promotion of...更多

Background: Nowadays, increasing attention has been paid on 'dignified death' and quality of life at the end of life. Instead of simply extending the length of life, hospice care patients with decision-making abilities begin to seek ways to make advance directives. As important participants in the process of making AD of patients, physicians and nurses' awareness of AD is directly associated with the promotion effect of AD. Objective: To explore the feasibility and practical path of promotion of AD by investigating the attitudes and behavioral intention concerning AD among physicians and nurses. Methods: From September to October 2019, stratified sampling and simple random sampling were adopted to select 540 medical workers from township hospitals and community health centers, and secondary and tertiary hospitals, Shandong Province. They received a questionnaire survey for collecting data regarding demographics, experience of encountering relatives' death and patients' death, attitudes towards AD and reasons, and so on. Multivariate Logistic regression was used to analyze the independent factors influencing their attitudes and behavioral intention concerning AD. Results: A total of 530 valid questionnaires were collected. Among the 530 respondents, 445 agreed with the directive living wills, and the first reason was 'Respecting the patient's right of choice'〔98.2%〕, while 85 disagreed with such living wills, with the first reason for disapproval being 'Do not know whether making directive living wills is legal'〔68.2%〕. 373 agreed with surrogate medical decision-making, and the first reason was 'It can reflect the patient's will'〔84.4%〕, but 157 disagreed with that, and the first reason was 'the patient's refusal to continue treatment may be subject to change by proxy'〔77.7%〕. 384 were willing to assist patients in making AD, 446 were delighted to introduce AD-related knowledge to others, and 257 were happy to sign a living will immediately. Logistic regression analysis revealed that physicians and nurses' willingness to help patients develop AD was influenced by many factors including age, experience of discussing AD with patients, and awareness of AD. Conclusion: Age and awareness of AD are associated with physicians and nurses' intention of helping the patient to make AD. AD-related trainings may improve their intention level, so the trainings should be strengthened through various ways.收起

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