Understanding advance care planning as a process of health behavior change.
Understanding advance care planning as a process of health behavior change.
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DOI：
10.1111/j.1532-5415.2009.02396.x
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发表时间：
2009-09
影响因子：
6.3
通讯作者：
O'Leary JR
中科院分区：
文献类型：
--
作者：
Fried TR;Bullock K;Iannone L;O'Leary JR
探讨健康行为改变模型是否有助于为ACP干预提供信息。定性横断面研究。社区63名年龄≥ 65岁的社区居民和30名具有代理决策者经验的护理人员。在分别与老年人和照顾者进行的重点小组讨论中，要求参与者讨论他们为未来健康状况下降所做的计划以及他们为什么进行或没有进行这种计划。使用扎根理论分析成绩单。四个主题说明了应用健康行为改变模型来改善ACP的潜力。1)参与者表现出参与ACP的不同准备程度，并且可能处于ACP不同组成部分的不同准备阶段，包括考虑治疗目标，完成预先指示以及与家人和医生的沟通。2)与会者指出了非加太集团的一系列好处和障碍。3)参与者使用各种变化过程来完成准备阶段，ACP只是参与者为健康状况下降或死亡做准备的一系列行为之一。4)与亲人的医疗决策的经验是一个强大的影响力的易感性和参与ACP的看法。参与者的准备程度、障碍和好处、对敏感性的看法以及为提高参与非加太方案每个组成部分的准备程度而使用的程序的差异表明，根据个性化评估采取针对具体阶段的干预措施有助于改进非加太方案。
To explore whether models of health behavior change can help to inform interventions for ACP. Qualitative cross-sectional study. Community Sixty-three community dwelling persons age ≥ 65 years and 30 caregivers with experience as surrogate decision-makers. In focus groups conducted separately with older persons and with caregivers, participants were asked to discuss ways they had planned for future declines in health and why they had or had not engaged in such planning. Transcripts were analyzed using grounded theory. Four themes illustrated the potential of applying models of health behavior change to improve ACP. 1) Participants demonstrated variable readiness to engage in ACP and could be in different stages of readiness for different components of ACP, including consideration of treatment goals, completion of advance directives, and communication with families and physicians. 2) Participants identified a wide range of benefits of and barriers to ACP. 3) Participants used a variety of processes of change to progress through stages of readiness, and ACP was only one of a broader set of behaviors that participants engaged in to prepare for declines in their health or for death. 4) Experience with healthcare decision-making for loved ones was a strong influence on perceptions of susceptibility and engagement in ACP. The variability in participants' readiness, barriers and benefits, perceptions of susceptibility, and use of processes to increase readiness_for participating in each component of ACP suggests the utility of tailored, stage-specific interventions based on individualized assessments to improve ACP.
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影响因子：
39.2
作者：
GILLICK, MR
通讯作者：
GILLICK, MR
影响因子：
2.8
作者：
Briggs, Linda
通讯作者：
Briggs, Linda
影响因子：
2.8
作者：
Kolarik, Russ C;Arnold, Robert M;Tulsky, James A
通讯作者：
Tulsky, James A
影响因子：
--
作者：
Curtis, JR;Patrick, DL;Collier, AC
通讯作者：
Collier, AC
DOI：
10.1097/01.jgp.0000216181.20416.b2
发表时间：
2006-05-01
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
--
作者：
Brodaty, Henry;Low, Lee-Fay;Burns, Kim
通讯作者：
Burns, Kim