頁籤選單縮合
題 名 | 老人與代理人對於末期醫療決策之一致性:系統性文獻回顧=The Congruence between the Elderly and Their Surrogates Concerning End-of-Life Decisions: A Systematic Review |
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作 者 | 柯莉珊; 胡文郁; | 書刊名 | 安寧療護 |
卷 期 | 19:1 2014.03[民103.03] |
頁 次 | 頁18-32 |
分類號 | 410.2、410.2 |
關鍵詞 | 老人; 代理人; 末期醫療決策; 一致性; Congruence; The elderly; Surrogates; End-of-life decisions; |
語 文 | 中文(Chinese) |
中文摘要 | 研究目的:以文獻回顧方式探討老人與代理人(surrogates)對於末期醫療決策的一致性、分析影響一致性之因素,以及提供增進一致性之措施。研究方法:利用關鍵字搜尋發表於華藝線上圖書館、CINAHL、Medline和Cochrane Library等資料庫之文章。結果:在老人與代理人對於末期醫療決策的一致性方面,因不同的研究使用不同的研究工具,且都提供不同的情境和不同的醫療處置進行測量,以致於難以進行統合分析,但老人和代理人對於目前健康狀況,若面臨心臟停止跳動是否進行急救的一致性為56~88%。在影響老人與代理人對於末期醫療決策的一致性方面,不願意拖累他人(reluctance to burden others; RBO)、老人和代理人的關係型態、家庭衝突、親密關係的經驗和預立照護計畫(advance care planning; ACP)會影響其一致性。在增進老人和代理人間對於末期醫療決策一致性的措施方面,發現利用影片和價值指標可以促進ACP的討論,並增加老人和代理人間的一致性。結論:目前國內對於促進老人與代理人於末期醫療決策一致性之相關研究闕如,建議未來相關研究能考慮使用影片和價值指標促進ACP的討論,以增進老人和代理人間對於末期醫療決策之一致性。 |
英文摘要 | Purpose: The study's purposes were to explore the congruence between the elderly and their surrogates about end-of-life decisions, to find the influencing factors affect the congruence, and to find the interventions to increase the congruence between the elderly and their surrogates concerning end-of-life decisions. Methods: Using keywords searched in MeSH, and then contributed to the strings to search articles published in Airiti Library, CINAHL, MEDLINE, and the Cochrane Library database. Results: The rate of congruence between the elderly and their surrogates about CPR in current health state was 56~88%. The reluctance to burden others (RBO), type of elder-proxy relationship, family conflict, experience in close relationships, and advance care planning (ACP) affected the congruence between the elderly and their surrogates concerning end-of-life decisions. Applying a video decision support tool and using value indicators into ACP discussion increased the congruence between the elderly and their surrogates concerning end-of-life decisions. Conclusions: There are few studies related with this issue in Taiwan. We suggest that video decision support tool and value indicators can be applied in clinical field to increase the congruence between the elderly and their surrogates concerning end-of-life decisions. |
本系統中英文摘要資訊取自各篇刊載內容。