Pediatric advance care planning.
Pediatric advance care planning.
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DOI：
10.1089/jpm.2005.8.766
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发表时间：
2005-08-01
影响因子：
2.8
通讯作者：
Williams, Marc S
中科院分区：
文献类型：
--
作者：
Hammes, Bernard J;Klevan, Judy;Williams, Marc S
目的：本研究描述了中西部一家医疗中心的儿科提前护理计划的过程和人群。结果和家长的看法，这一计划也进行了讨论。方法：从伦理咨询记录中确定有预先指示的儿科患者。关于预先指示的类型、病人的医疗状况和接受的护理的信息是从医疗记录中获得的。然后与孩子的父母取得联系，并就为他们的孩子所做的预先护理计划过程进行了采访。这些采访都有录音和文字记录。审查了采访记录并确定了主题。结果：来自16个家庭的17名儿童被纳入研究。除癌症外，几乎所有患者都患有进行性疾病。在17名儿童中，9人死亡，7人在家中死亡，2人在医院死亡。8名儿童在死亡过程中遵循了预先指示，1名没有。13位家长接受了采访。12名妇女表示，预先护理计划的过程使她们的子女和家庭受益。社区中很少有人对孩子的预先指示表示担忧。结论：尽管孩子的死亡是一个困难的话题，但大多数受访家长认为，预先制定孩子的护理计划过程是有帮助的，因为它确保了孩子得到最好的照顾，包括保持孩子的生活质量，避免不必要的痛苦。
OBJECTIVE: This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed.METHODS: Pediatric patients with advance directives were identified from ethics consultations records. Information about the type of advance directive, the patient's medical condition and care received was obtained from the medical records. Parents of the children were then contacted and interviewed in regard to the advance care planning process done for their child. The interviews were audiotaped and transcribed. Transcribed interviews were reviewed and themes were identified.RESULTS: Seventeen children from 16 families were included in the study. Almost all of the patients had progressive disorders other than cancer. Of the 17 children, 9 are deceased, 7 died at home and 2 died at a hospital. Eight of the children's advance directives were followed during the dying process, while 1 was not. Thirteen parents were interviewed. Twelve stated that the process of advance care planning benefited their children and their family. Rarely, individuals in the community raised concerns about the child's advance directive.CONCLUSIONS: Even though the topic of their child's death is difficult, the majority of the interviewed parents found the advance care planning process for the child helpful because it assured the best care for the child, including preserving their child's quality of life and avoiding unnecessary suffering.