Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer.
Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer.
复制标题
影响患有晚期癌症的非裔美国人临终决策的因素。
DOI：
10.1016/j.jpainsymman.2010.10.189
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Orr,Tamara
中科院分区：
文献类型：
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作者：
Campbell,CathyL;Williams,IshanC;Orr,Tamara
意义 与患有相同诊断的白人患者相比，患有癌症的非裔美国人不太可能使用临终关怀服务，并且更有可能在医院死亡。然而，对于导致非裔美国人选择临终关怀的因素，人们尚不了解。设计 本试点研究采用了定性、描述性设计。方法 对两组患有晚期癌症的非裔美国人（参加临终关怀的人和未接受临终关怀的人）进行访谈。研究结果 临终决策主要由临床因素、患者相关的身体、情绪和认知症状（基础疾病或药物治疗的后遗症）指导。医生是最有可能参与患者、家庭成员和护理人员决策的医疗保健提供者。个人因素，例如个人信仰，影响临终决策。宗教和灵性是许多采访中的主题，但它们并没有始终如一地影响决策。讨论 未来的研究应包括对家庭成员、护理人员和医疗保健专业人员的访谈，以便能够充分描述影响临终决策的因素。未来的方案中需要添加促进招募的策略。
Significance African Americans with cancer are less likely to use hospice services and more likely to die in the hospital than white patients with the same diagnosis. However, there is much that is not understood about the factors that lead African Americans to choose options for end-of-life care. Design A qualitative, descriptive design was used in this pilot study. Methods Interviews were conducted with two groups of African Americans with advanced-stage cancer (people enrolled in hospice and those who were not under hospice care). Findings End-of-life decisions were primarily guided by clinical factors, the patient-related physical, emotional, and cognitive symptoms that are sequelae of the underlying disease or medical treatments. The physician was the healthcare provider most likely to be involved in decision making with patients, family members, and caregivers. Individual factors, such as personal beliefs, influenced end-of-life decision making. Religion and spirituality were a topic in many interviews, but they did not consistently influence decision making. Discussion Future studies should include interviews with family members, caregivers, and healthcare professionals so that factors that impact end-of-life decision making can be fully described. Strategies to facilitate recruitment will need to be added to future protocols.