The state of advance care planning: one decade after SUPPORT.
The state of advance care planning: one decade after SUPPORT.
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DOI：
10.1177/1049909106292171
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发表时间：
2006-10-01
期刊：
影响因子：
--
通讯作者：
Winter, Laraine
中科院分区：
文献类型：
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作者：
Collins, Lauren G;Parks, Susan M;Winter, Laraine
研究了解预后和偏好的结果和风险的治疗（支持）是一个具有里程碑意义的研究关于临终决策和提前护理计划。研究的第一阶段观察了不同医院的临终状态，第二阶段实施了一项由护士协助的干预措施，旨在改善预先护理计划、医患沟通和临终过程。观察阶段发现生命末期护理质量较差，干预未能改善目标结果。这些消极的发现使公众注意到需要改善对临终者的护理，并催生了大量关于生命末期决策的额外研究。自“支持计划”以来的十年里，研究人员定义了“善终”的属性，探讨了预先指示在预先护理计划中的作用，并研究了在生命结束时使用替代决策的情况。这重新点燃了关于预先护理计划的讨论，并挑战卫生保健提供者设计更灵活的方法来结束生命护理。
The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) was a landmark study regarding end-of-life decision making and advance care planning. Phase I of the study looked at the state of end of life in various hospitals, and phase II implemented a nurse-facilitated intervention designed to improve advance care planning, patient-physician communication, and the dying process. The observational phase found poor quality of care at the end of life and the intervention failed to improve the targeted outcomes. The negative findings brought public attention to the need to improve care for the dying and spawned a wealth of additional research on decision-making at the end of life. In the decade since SUPPORT, researchers have defined the attributes of a "good death," addressed the role of advance directives in advance care planning, and studied the use of surrogate decision-making at the end of life. This rekindled the discussion on advance care planning and challenged health care providers to design more flexible approaches to end of life care.