PHYSICIAN RELUCTANCE TO DISCUSS ADVANCE DIRECTIVES - AN EMPIRIC INVESTIGATION OF POTENTIAL BARRIERS
PHYSICIAN RELUCTANCE TO DISCUSS ADVANCE DIRECTIVES - AN EMPIRIC INVESTIGATION OF POTENTIAL BARRIERS
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DOI：
10.1001/archinte.154.20.2311
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发表时间：
1994-10-24
影响因子：
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通讯作者：
GLICKMAN, DF
中科院分区：
文献类型：
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作者：
MORRISON, RS;MORRISON, EW;GLICKMAN, DF
背景：为了确定五个拟议的障碍对医生使用提前指令的相对影响，目的是增加预先指令的生成数量。方法：向纽约一家大型医院的460名内科住院医生和主治医生发出问卷。在这些投诉中，有277宗(60%)有回应。我们使用多元回归的方法来衡量医生发起的先行指令讨论的五个障碍(时间限制、补偿问题、对主题的不适感、对适当性的信念和缺乏理解)对受访者对被调查者的患者持有的先行指令的数量、最近先行指令讨论的数量以及医生发起的讨论数量的估计的影响。结果：医生缺乏理解和关于适宜性的错误信念对最近的先行指令讨论的影响尤其强烈，成为最近先行指令讨论的障碍(P
Background: To determine the relative impact of five proposed barriers to physician usage of advance directives with the aim of increasing the number of advance directives generated.Methods: Questionnaires were sent to 460 internal medicine resident and attending physicians at a large New York, NY, hospital. Of these, 277 (60%) responded. We used multiple regression to measure the impact of five barriers to physician-initiated discussions of advance directives (time constraints, compensation concerns, discomfort with the subject, beliefs about appropriateness, and lack of understanding) on respondents' estimates of the number of advance directives held by respondents' patients, the number of recent advance directive discussions, and the number of discussions initiated by physicians.Results: Physician lack of understanding and erroneous beliefs about appropriateness had particularly strong effects, serving as barriers to recent advance directive discussions (P