Redefining the "planning" in advance care planning: preparing for end-of-life decision making.
Redefining the "planning" in advance care planning: preparing for end-of-life decision making.
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DOI：
10.7326/0003-4819-153-4-201008170-00008
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发表时间：
2010-08-17
影响因子：
39.2
通讯作者：
Fried TR
中科院分区：
文献类型：
--
作者：
Sudore RL;Fried TR
预先护理计划的传统目标是让患者提前做出治疗决定，以提供与其目标一致的护理。我们认为，提前护理计划的目标应该是准备病人和代理人参与临床医生在尽可能最好的时刻医疗决策。我们为临床医生提供实际步骤，帮助患者和代理决策者在门诊环境中实现这一目标。为即时决策做准备将重点从让患者根据不完整的信息做出过早的决定转移到让患者及其代理人为他们在不得不参与即时决策时可能遇到的决策和冲突类型做好准备。这种做法并不排除完成预先指示，但承认它们只是在决策时使用的一条信息。
The traditional objective of advance care planning has been to have patients make treatment decisions in advance in an attempt to provide care consistent with their goals. We argue that the objective for advance care planning ought to be the preparation of patients and surrogates to participate with clinicians in making the best possible in-the-moment medical decisions. We provide practical steps for clinicians to help patients and surrogate decision makers achieve this objective in the outpatient setting. Preparation for in-the-moment decision making shifts the focus from having patients make premature decisions based on incomplete information to preparing patients and their surrogates for the types of decisions and conflicts they may encounter when they do have to engage in in-the-moment decision making. This approach does not preclude the completion of advance directives, but acknowledges that they are but one piece of information to be used at the time of decision making.
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影响因子：
--
作者：
Fried, TR;Byers, AL;Dubin, JA
通讯作者：
Dubin, JA
影响因子：
168.9
作者：
Fallowfield, L;Jenkins, V;Eves, R
通讯作者：
Eves, R
影响因子：
168.9
作者：
Chochinov, HM;Tataryn, D;Dudgeon, D
通讯作者：
Dudgeon, D
影响因子：
2.8
作者：
Briggs, Linda
通讯作者：
Briggs, Linda
影响因子：
5.7
作者：
Fried, Terri R.;O'Leary, John R.
通讯作者：
O'Leary, John R.