Differences in End-of-life Care Decision Making Between Patients With and Without Cancer
Differences in End-of-life Care Decision Making Between Patients With and Without Cancer
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DOI：
10.1177/1049909114542646
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发表时间：
2015-12-01
影响因子：
1.9
通讯作者：
Oh, So Yeon
中科院分区：
文献类型：
--
作者：
Park, In Ki;Jun, Hyun Jung;Oh, So Yeon
背景：当康复可能性不大时，大多数患者和家属不希望接受侵入性生命维持手术。我们比较了患有和未患有癌症的患者的预先医疗指示 (AD) 的临床特征。方法：AD 是通过回顾性审查 2011 年 4 月至 2012 年 7 月期间死亡的 699 名连续患者的电子病历而获得的。结果：癌症患者更有可能写下预先医疗指示：265 名 (85.8%) 癌症患者和 277 名 (71.0%) 非癌症患者 (P < .001)。入住重症监护病房的非癌症患者明显增多，这表明他们已经接受或正在接受侵入性治疗。与癌症患者相比，非癌症患者更频繁地要求维持生命治疗，但症状控制的频率较低。结论：对于患有无法治愈的非癌症疾病的患者，预先制定护理计划对于保证患者在临终时的自主权非常重要。
Background: Most patients and families do not want invasive life-sustaining procedures when recovery is unlikely. We compared the clinical features of advance directives (ADs) of patients with and without cancer.Methods: The ADs were obtained from retrospectively reviewing electronic medical records of 699 consecutive patients who died from April 2011 to July 2012.Results: Patients with cancer were more likely to have written ADs: 265 (85.8%) patients with cancer and 277 (71.0%) noncancer patients (P < .001). Significantly more noncancer patients were in the intensive care unit, indicating that they had received or were receiving invasive treatments. Noncancer patients requested life-sustaining treatment more frequently but symptom control less frequently than patients with cancer.Conclusion: Advance care planning in patients with incurable, noncancer disease is important to guarantee patient autonomy at the end of life.