Advance directives: cancer patients' preferences and family-based decision making.
Advance directives: cancer patients' preferences and family-based decision making.
复制标题
预先指示：癌症患者的偏好和基于家庭的决策
DOI：
10.18632/oncotarget.17525
复制
发表时间：
2017-07-11
期刊：
影响因子：
--
通讯作者：
Wu XY
中科院分区：
文献类型：
--
作者：
Xing YF;Lin JX;Li X;Lin Q;Ma XK;Chen J;Wu DH;Wei L;Yin LH;Wu XY
背景预先指示在传统的中国人中是一个敏感的问题，他们通常在必要时才提到这个话题。癌症患者的医疗决定是由他们的家人做出的，这些决定可能会违反患者的个人意愿。目的本研究旨在考察中国癌症患者及其家属对预先指示的接受程度以及患者参与该程序的情况，并分析其中涉及的道德风险。结果246例患者及其家属拒绝正式讨论预先指令，其余166例患者及其家属接受预先指令的概念，并签署了一份文件，同意在抗癌治疗终止时放弃侵入性治疗。其中，只有24名患者参与了决策。在101名患者中，抗癌治疗提前结束，多达37名患者没有被告知他们可能会失去健康利益。材料与方法研究对象为来自全国9家重点医院的412例成人肿瘤患者。向每一位病人的主要决策者介绍了一份预先指示;如果他们愿意签署，将系统地讨论预先指示。向负责每位患者的肿瘤学家发放问卷，以评估家属与患者之间的互动、患者对疾病的认识以及参与预先指导。结论中国癌症患者对预嘱的接受程度不高，除非终止抗癌治疗。大多数癌症患者被排除在预先指令的讨论之外。
Background Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients’ personal will. Objectives This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. Results While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Materials and Methods Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients’ awareness of their disease, and participation in an advance directive. Conclusions Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.
登录
查看更多内容
DOI：
10.1177/1049909114542646
发表时间：
2015-12-01
影响因子：
1.9
作者：
Park, In Ki;Jun, Hyun Jung;Oh, So Yeon
通讯作者：
Oh, So Yeon
影响因子：
120.7
作者：
Sessums, Laura L.;Zembrzuska, Hanna;Jackson, Jeffrey L.
通讯作者：
Jackson, Jeffrey L.
影响因子：
1.9
作者：
Jo, Kae-Hwa;An, Gyeong-Ju;Han, Kyung Su
通讯作者：
Han, Kyung Su
影响因子：
1.4
作者：
Fan, Ruiping
通讯作者：
Fan, Ruiping
DOI：
10.2165/11531800-000000000-00000
发表时间：
2011-01-01
影响因子：
3.6
作者：
Hougaard, Jens;Osterdal, Lars;Yu, Yi
通讯作者：
Yu, Yi