目的了解养老机构慢性病老年人对预立医疗照护计划(advance care planning,ACP)的接受程度及其影响因素。方法2019年7-10月,采用便利抽样法选择重庆市主城9个行政区内27所养老机构的515例慢性病老年人为研究对象,采用一般资料调查表、AC...目的了解养老机构慢性病老年人对预立医疗照护计划(advance care planning,ACP)的接受程度及其影响因素。方法2019年7-10月,采用便利抽样法选择重庆市主城9个行政区内27所养老机构的515例慢性病老年人为研究对象,采用一般资料调查表、ACP接受程度问卷对其进行调查。结果养老机构慢性病老年人ACP接受程度总分为(61.29±11.74)分,处于中等水平,考虑讨论ACP的占42.7%。多元回归分析结果显示,ACP了解情况、接触濒死者经历、日常生活活动能力及月收入是影响慢性病老年人ACP接受程度的主要因素。结论养老机构慢性病老年人ACP接受程度呈中等水平,可结合影响因素选定ACP优先推广对象,积极开展ACP宣教。展开更多
目的探讨社区居民参与预立医疗照护计划的促进与阻碍因素,为预立医疗照护计划的推广实践提供参考。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、维普网、万方数据库建库至2022年2月发表的关于社区居民...目的探讨社区居民参与预立医疗照护计划的促进与阻碍因素,为预立医疗照护计划的推广实践提供参考。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、维普网、万方数据库建库至2022年2月发表的关于社区居民参与预立医疗照护计划真实体验的质性研究,采用汇集性整合方法进行Meta整合。结果纳入12篇文献,提炼53个结果,经分析汇总成14个类别,最终进一步归纳成4个整合结果,即社区居民对预立医疗照护计划的认识、社区居民对预立医疗照护计划的态度、社区居民参与预立医疗照护计划的影响因素及对实施预立医疗照护计划的建议。结论社区居民对预立医疗照护计划的认知不足,社区医务人员需加强社区预立医疗照护计划推广宣传,同时丰富社区预立医疗照护计划实践方式,促进“以家庭为中心”的预立医疗照护计划干预模式。展开更多
目的系统评价养老机构老年人及家属参与预立医疗照护计划(advance care planning,ACP)的质性研究。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、中国知网、万方数据库、维普等数据库中养老机构老年人及...目的系统评价养老机构老年人及家属参与预立医疗照护计划(advance care planning,ACP)的质性研究。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、中国知网、万方数据库、维普等数据库中养老机构老年人及家属参与ACP的质性研究,检索时限为建库至2024年3月,采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)质性研究质量评价标准进行文献质量评价,采用汇集性整合法进行结果整合。结果共纳入9篇文献,提炼24个研究结果,归纳为8个新类别,综合出4个整合结果:养老机构老年人及家属参与ACP态度不一致、养老机构老年人及家属参与ACP的益处、养老机构老年人及家属参与ACP的障碍、养老机构老年人及家属对ACP的实施建议。结论养老机构应组建ACP跨专业协作团队,强化信息支持,改变老年人及家属的负面态度,定期召开家庭会议,减轻家属决策负担。展开更多
This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directiv...This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.展开更多
文摘目的了解养老机构慢性病老年人对预立医疗照护计划(advance care planning,ACP)的接受程度及其影响因素。方法2019年7-10月,采用便利抽样法选择重庆市主城9个行政区内27所养老机构的515例慢性病老年人为研究对象,采用一般资料调查表、ACP接受程度问卷对其进行调查。结果养老机构慢性病老年人ACP接受程度总分为(61.29±11.74)分,处于中等水平,考虑讨论ACP的占42.7%。多元回归分析结果显示,ACP了解情况、接触濒死者经历、日常生活活动能力及月收入是影响慢性病老年人ACP接受程度的主要因素。结论养老机构慢性病老年人ACP接受程度呈中等水平,可结合影响因素选定ACP优先推广对象,积极开展ACP宣教。
文摘目的探讨社区居民参与预立医疗照护计划的促进与阻碍因素,为预立医疗照护计划的推广实践提供参考。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、维普网、万方数据库建库至2022年2月发表的关于社区居民参与预立医疗照护计划真实体验的质性研究,采用汇集性整合方法进行Meta整合。结果纳入12篇文献,提炼53个结果,经分析汇总成14个类别,最终进一步归纳成4个整合结果,即社区居民对预立医疗照护计划的认识、社区居民对预立医疗照护计划的态度、社区居民参与预立医疗照护计划的影响因素及对实施预立医疗照护计划的建议。结论社区居民对预立医疗照护计划的认知不足,社区医务人员需加强社区预立医疗照护计划推广宣传,同时丰富社区预立医疗照护计划实践方式,促进“以家庭为中心”的预立医疗照护计划干预模式。
文摘目的系统评价养老机构老年人及家属参与预立医疗照护计划(advance care planning,ACP)的质性研究。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、中国知网、万方数据库、维普等数据库中养老机构老年人及家属参与ACP的质性研究,检索时限为建库至2024年3月,采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)质性研究质量评价标准进行文献质量评价,采用汇集性整合法进行结果整合。结果共纳入9篇文献,提炼24个研究结果,归纳为8个新类别,综合出4个整合结果:养老机构老年人及家属参与ACP态度不一致、养老机构老年人及家属参与ACP的益处、养老机构老年人及家属参与ACP的障碍、养老机构老年人及家属对ACP的实施建议。结论养老机构应组建ACP跨专业协作团队,强化信息支持,改变老年人及家属的负面态度,定期召开家庭会议,减轻家属决策负担。
文摘This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.
