頁籤選單縮合
題 名 | Physicians' Attitudes Toward DNR of Terminally Ill Cancer Patients in Taiwan=醫師對末期癌症病人臨終時不予急救之態度 |
---|---|
作 者 | 趙可式; | 書刊名 | The Journal of Nursing Research |
卷 期 | 10:3 2002.09[民91.09] |
頁 次 | 頁161-167 |
分類號 | 419.77 |
關鍵詞 | 心肺復甦急救術; 不予心肺復甦急救術; 末期癌症病患; 預立指示; 自然死; CPR; Cardiopulmonary resuscitation; DNR; Do not resuscitate; Terminally ill cancer patients; Advance directives; Natural death; |
語 文 | 英文(English) |
中文摘要 | 本研究的主要目的是調查臺灣醫師對末期癌症病人臨終時不予急救的態度。研究對象為內科及外科醫師,研究工具為結構式問卷,內含一個臨床情境及六個問題。研究過程為對目前臺灣內科及外科醫學會會員醫師,郵寄發出7626份結構式問卷,回收有效問卷1328份,回收率17.6%。研究結果為77.6%受調醫師同意在告知末期病患或其家屬病情後,會考慮請他們簽不予急救的同意書;58.4%醫師不知臺灣的法律是否允許自然死。而96.1%醫師認為若要同意病患的自主權不予急救,必須有法律的保障。41.2%受調醫師承認他們並無正式的不予急救同意書可用;在有正式同意書可用的調查對象中,只有27.4%醫師之機構給予清楚的填寫指南。在623位其機構提供同意書的醫師中,63.7%認為這些同意書合理地被使用。而令人驚訝的是67.9%的醫師曾有「假裝急救」的經驗。此研究的結果成為研究者及其同道提出以說服立法委員的根據,使能通過「自然死」之立法。然而某些立法委員不喜歡「死」這個詞彙,由於推動者多為安寧緩和醫療界人士,因此最後終於在2000年5月23日通過改名為「安寧緩和醫療條例」之法律,成為末期病患不予急救的法律依據。本研究之限制為較低之問卷回收率,但因醫師的忙碌工作負荷,17.6%仍為可接受之回收率。 |
英文摘要 | The purpose of this study was to survey physicians' attitudes toward DNR of terminally ill cancer patients in Taiwan. A total of 7626 structured questionnaires were sent by mail to physicians who were members of the Taiwan Society of Internal Medicine and the Surgical Association of Taiwan, and 1328 valid responses were received. The response rate was 17.6%. The instrument, a structured questionnaire, was composed of one scenario and six questions. A majority (77.6%) of the physicians under investigation would tell a terminally ill cancer patient or his family about the possibility of DNR and ask them to consider signing a consent form. Over one half of the physicians (58.4%) did not know whether the Medical Law in Taiwan permits natural death, and 96.1% of the subjects felt they would need legal protection for agreeing patient's autonomy to decide DNR. Unfortunately, 41.2% of the respondent admitted that they did not have a formal Informed Consent Form that could be used for DNR. Even of those who had such a form, only 27.4% had clear guidelines given by their institutions. Among 623 physicians whose institutions had an formal Informed Consent Form for DNR, 63.7% agreed that it was reasonably used. Surprisingly, 67.9% of the physicians had used Slow Codes. The findings of this study served as a solid base. The investigator and other colleagues used it to convince legislators to pass a Natural Death Act in Taiwan. Since some legislators disliked the term "death" and the main promotes were people engaged in hospice palliative care, the new law entitled "Hospice Palliative Act" was passed on May 23, 2000. The DNR order finally gained its legal base for medical practice. The limitation of this study was the low response rate. However, since the subjects, physicians, had a busy work load, this was still an acceptable response rate. |
本系統中英文摘要資訊取自各篇刊載內容。