Factors considered important at the end of life by patients, family, physicians, and other care providers
Factors considered important at the end of life by patients, family, physicians, and other care providers
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DOI：
10.1001/jama.284.19.2476
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发表时间：
2000-11-15
影响因子：
120.7
通讯作者：
Tulsky, JA
中科院分区：
文献类型：
--
作者：
Steinhauser, AE;Christakis, NA;Tulsky, JA
清楚地了解患者、家属和医疗保健从业者在生命结束时认为重要的是什么，是改善临终患者护理的成功不可或缺的。目的确定患者、家属、医生和其他护理人员在生命结束时认为重要的因素。设计和设置1999年3 - 8月进行的横断面、分层随机全国调查。医生（n = 361）和其他护理提供者（护士、社会工作者、牧师和临终关怀志愿者; n = 429）。主要结果测量生命末期44个质量属性的重要性（5分制）和9个主要属性的排名，结果有26个项目被一致认为是重要的（>70%的人认为这一项目很重要），包括疼痛和症状管理、死亡准备、实现完成感、关于治疗偏好的决定，并被当作一个“完整的人”来对待。“8个项目获得了患者的强烈重要性评级，但医生的重要性较低（P
Context A clear understanding of what patients, families, and health care practitioners view as important at the end of life is integral to the success of improving care of dying patients. Empirical evidence de fining such factors, however, is lacking.Objective To determine the factors considered important at the end of life by patients, their families, physicians, and other care providers.Design and Setting Cross-sectional, stratified random national survey conducted in March-August 1999.Participants Seriously ill patients (n = 340), recently bereaved family (n = 332), physicians (n = 361), and other care providers (nurses, social workers, chaplains, and hospice volunteers; n = 429).Main Outcome Measures Importance of 44 attributes of quality at the end of life (5-point scale) and rankings of 9 major attributes, compared in the 4 groups.Results Twenty-six items consistently were rated as being important (>70% responding that item is important) across all 4 groups, including pain and symptom management, preparation for death, achieving a sense of completion, decisions about treatment preferences, and being treated as a "whole person." Eight items received strong importance ratings from patients but less from physicians (P