Why oregon patients request assisted death: Family members' views
Why oregon patients request assisted death: Family members' views
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DOI：
10.1007/s11606-007-0476-x
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发表时间：
2008-02-01
影响因子：
5.7
通讯作者：
Dobscha, Steven K.
中科院分区：
文献类型：
--
作者：
Ganzini, Linda;Goy, Elizabeth R.;Dobscha, Steven K.
背景：医生协助死亡 (PAD) 于 1994 年通过俄勒冈州尊严死亡法案合法化，并于 1997 年颁布。 目的：本文的目的是向家庭成员了解其亲人要求 PAD 的原因。设计：本研究采用横断面调查。参与者：本研究的参与者包括 83 名俄勒冈州死者的家庭成员，他们在去世前明确要求 PAD 合法化。死亡人数，包括 52 名死者 其中 32 人死于 PAD。测量：家庭成员按照 1-5 Likert 量表，对亲人请求 PAD 的 28 种可能原因的重要性进行评分，分数越高代表重要性越高。结果：根据家庭成员的说法，亲人请求 PAD 的最重要原因（中位数均为 4.5 或更高）是希望控制死亡情况并在家中去世，并担心失去尊严 以及未来失去独立性、生活质量和自理能力。在提出请求时，没有身体症状的重要性评分高于中位数 2。一般来说，对未来症状和经历的担忧比提出请求时的症状或经历更重要。据家庭成员称，他们的亲人请求 PAD 的最不重要的原因包括抑郁、经济问题和社会支持不佳。结论：帮助患者在家庭环境中保持控制、独立和自我护理的干预措施可能是解决严重 PAD 请求的有效方法。
BACKGROUND: Physician assisted death (PAD) was legalized through Oregon's Death with Dignity Act in 1994 and enacted in 1997.OBJECTIVE: The objective of this paper was to learn from family members why their loved ones requested PAD.DESIGN: This study used the cross-sectional survey.PARTICIPANTS: Participants of this study included family members of 83 Oregon decedents who made explicit requests for legalized PAD before their deaths, including 52 decedents who received prescriptions for a lethal medication and 32 who died of PAD.MEASUREMENTS: Family members rated the importance of 28 possible reasons their loved ones requested PAD on a 1-5 Likert scale, with higher scores representing greater importance.RESULTS: According to family members, the most important reasons that their loved ones requested PAD, all with a median score of 4.5 or greater, were wanting to control the circumstances of death and die at home, and worries about loss of dignity and future losses of independence, quality of life, and self-care ability. No physical symptoms at the time of the request were rated higher than a median of 2 in importance. Worries about symptoms and experiences in the future were, in general, more important reasons than symptoms or experiences at the time of the request. According to family members, the least important reasons their loved ones requested PAD included depression, financial concerns, and poor social support.CONCLUSIONS: Interventions that help patients maintain control, independence, and self-care in a home environment may be effective means of addressing serious requests for PAD.