Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.
Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.
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DOI：
10.1136/bmjpo-2017-000102
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发表时间：
2017
影响因子：
2.6
通讯作者：
Shintaku H
中科院分区：
文献类型：
--
作者：
Yotani N;Kizawa Y;Shintaku H
评估目前的态度和障碍，以提前护理计划的青少年患者有生命危险的条件之间的儿科神经科医生。横断面研究。管理自我报告的问卷调查，以评估的做法，提前护理计划，提前指示和障碍，提前护理计划的青少年患者的生命受到威胁的条件。所有委员会认证的儿科神经科医生在日本进行了调查，并对那些谁在照顾青少年患者的决策能力的经验进行了分析。我们将结果与先前报道的儿科血液学家的结果进行了比较。共对186名儿科神经科医生进行了分析。如果患者的预后<3个月，只有约30%的儿科神经科医生报告与患者进行过讨论，例如“不要尝试复苏”命令（28%）和呼吸机使用（32%），而超过70%的人确实与患者讨论过这些话题患者的家人。大约一半的儿科神经科医生没有在生命结束时与患者讨论预先指示，而超过75%的儿科神经科医生与患者家属讨论了预先指示。与儿科血液科医生相比，儿科神经科医生与患者进行了更多的临终讨论，例如将在哪里进行治疗和护理，不要尝试复苏命令，以及如果患者的预后>1年，则使用呼吸机。大约一半或更少的儿科神经科医生与患有危及生命的疾病的青少年患者讨论了预先护理计划和预先指示，即使患者的预后<3个月。他们倾向于与家属讨论预先护理计划和预先指示，而不是与患者本人。
To evaluate current attitudes and barriers to advance care planning for adolescent patients with life-threatening conditions among paediatric neurologists. Cross-sectional study. A self-reported questionnaire was administered to assess the practice of advance care planning, advance directives and barriers to advance care planning for adolescent patients with life-threatening conditions. All board-certified paediatric neurologists in Japan were surveyed and those who had experience in taking care of adolescent patients with decision-making capacity were analysed. We compared the results with those of paediatric haematologists reported previously. In total, 186 paediatric neurologists were analysed. If the patient’s prognosis was <3 months, only about 30% of paediatric neurologists reported having discussions with patients, such as ‘do not attempt resuscitation’ orders (28%) and ventilator use (32%), whereas more than 70% did discuss these topics with patients’ families. About half of the paediatric neurologists did not discuss advance directives at the end of life with their patients, whereas over 75% did discuss advance directives with patients’ families. Compared with paediatric haematologists, paediatric neurologists had more end-of-life discussions with patients, such as where treatment and care will take place, do not attempt resuscitation orders, and the use of a ventilator, if the patient’s prognosis was >1 year. About half or less of the paediatric neurologists discussed advance care planning and advance directives with their adolescent patients who had life-threatening conditions, even if the patient’s prognosis was <3 months. They tended to discuss advance care planning and advance directives more with families than with patients themselves.
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影响因子：
4.4
作者：
Lotz JD;Jox RJ;Borasio GD;Führer M
通讯作者：
Führer M
影响因子：
3.2
作者：
Jacobs, Shana;Perez, Jennie;Lyon, Maureen E.
通讯作者：
Lyon, Maureen E.
影响因子：
7.6
作者：
Lyon, Maureen E.;Jacobs, Shana;Wang, Jichuan
通讯作者：
Wang, Jichuan
影响因子：
8
作者：
Durall, Amy;Zurakowski, David;Wolfe, Joanne
通讯作者：
Wolfe, Joanne
DOI：
10.1177/1049909113507328
发表时间：
2014-11-01
影响因子：
1.9
作者：
Nakazawa, Kazuhiro;Kizawa, Yoshiyuki;Maeno, Tetsuhiro
通讯作者：
Maeno, Tetsuhiro