Goals of Care Conversations and Subsequent Advance Care Planning Outcomes for People with Dementia.
Goals of Care Conversations and Subsequent Advance Care Planning Outcomes for People with Dementia.
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DOI：
10.3233/jad-210720
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发表时间：
2021
影响因子：
4
通讯作者：
Chiong, Winston
中科院分区：
文献类型：
--
作者：
Ma, Heather;Kiekhofer, Rachel E.;Hooper, Sarah M.;Dulaney, Sarah;Possin, Katherine L.;Chiong, Winston
预先的护理计划已被证明可以改善痴呆症患者的临终决策。然而，痴呆症患者与其照顾者之间的护理目标对话的影响尚未被描述。在本研究中，我们评估了护理谈话目标与提前护理计划结果之间的关系。通过问卷调查收集了166名护理人员在痴呆症患者去世后的回顾性预先护理计划措施。在死亡时，大多数患有痴呆症的死者都有预先指示，医疗保健代理人，以及与护理者之前的护理目标对话。护理谈话的目标与预先指示的感知有用性、对预先指示的感知依从性和死者在他们期望的死亡地点死亡显著相关，但与临终关怀的分歧无关。我们的研究结果表明，护理谈话的目标是预先护理计划的重要组成部分。这些发现支持开发干预措施，促进痴呆症患者与其照顾者之间的这种对话。
Advance care planning has been shown to improve end of life decision-making for people with dementia. However, the impact of goals of care conversations between people with dementia and their caregivers has not been characterized. In this study, we evaluate the association between goals of care conversations and advance care planning outcomes. Retrospective advance care planning measures were collected via a questionnaire administered to 166 caregivers after the death of the person with dementia for whom they provided care. At time of death, the majority of decedents with dementia had advance directives, health care agents, and previous goals of care conversations with their caregiver. Goals of care conversations were significantly associated with the perceived usefulness of advance directives, the perceived adherence to advance directives, and decedent dying at their desired place of death, but not with disagreements around end of life care. Our findings suggest that goals of care conversations are an important component of advance care planning. These findings support the development of interventions that facilitate such conversations between people with dementia and their caregivers.