Nurse involvement in end-of-life decision making: the ETHICUS Study
Nurse involvement in end-of-life decision making: the ETHICUS Study
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DOI：
10.1007/s00134-005-2864-1
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发表时间：
2006-01-01
影响因子：
38.9
通讯作者：
Sprung, CL
中科院分区：
文献类型：
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作者：
Benbenishty, J;Ganz, FD;Sprung, CL
目的：调查医师对欧洲重症监护护士在临终决策中所扮演角色的看法。设计：本研究是由欧洲重症监护医学会伦理学分会赞助的一项大型研究（ETHIUS研究）的一部分。医生描述了他们是否认为护士参与了这样的决定，护士是否发起了这样的讨论，医生和护士之间是否达成了协议。对这些项目进行了分析，并在欧洲不同地区之间进行了比较。背景：该研究在17个欧洲国家的37个重症监护病房进行。患者和参与者：医生研究者报告了来自17个欧洲国家37个中心的患者相关数据。干预：无。测量和结果：医生认为护士参与了3，086个临终决策（EOLD）中的2，412个（78.3%）。66例（2.1%）被认为是护士发起的讨论，2,438例（79.3%）被认为是ICU医生发起的讨论，328例（10.7%）被认为是主治医生发起的讨论，105例（3.4%）被认为是咨询医生发起的讨论，119例（3.9%）被认为是家属发起的讨论，19例（0.6%）被认为是患者发起的讨论。只有20个答复（0.6%），医生报告医生和护士之间的分歧有关EOLD。一个显着的关联被发现之间的区域和反应有关的护理项目。更多北方地区的医生报告了更多的护士参与。结论：医生认为护士在很大程度上参与了EOLD，但不是发起讨论。一旦做出决定，就会有一种认同感。不同区域的参与程度不同。
Objective: The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making. Design: This study was part of a larger study sponsored by the Ethics Section of the European Society of Intensive Care Medicine, the ETHICUS Study. Physicians described whether they thought nurses were involved in such decisions, whether nurses initiated such a discussion and whether there was agreement between physicians and nurses. The items were analyzed and comparisons were made between different regions within Europe. Setting: The study took place in 37 intensive care units in 17 European countries. Patients and participants: Physician investigators reported data related to patients from 37 centers in 17 European countries. Interventions: None. Measurements and results: Physicians perceived nurses as involved in 2,412 (78.3%) of the 3,086 end-of-life decisions (EOLD) made. Nurses were thought to initiate the discussion in 66 cases (2.1%), while ICU physicians were cited in 2,438 cases (79.3%), the primary physician in 328 cases (10.7%), the consulting physician in 105 cases (3.4%), the family in 119 cases (3.9%) and the patient in 19 cases (0.6%). In only 20 responses (0.6%) did physicians report disagreement between physicians and nurses related to EOLD. A significant association was found between the region and responses to the items related to nursing. Physicians in more northern regions reported more nurse involvement. Conclusions: Physicians perceive nurses as involved to a large extent in EOLDs, but not as initiating the discussion. Once a decision is made, there is a sense of agreement. The level of perceived participation is different for different regions.