MEASUREMENT OF PREFERENCES FOR LIFE-SUSTAINING TREATMENT

生命维持治疗偏好的衡量

• 批准号: 3371957
• 负责人: RICHARD F UHLMANN
• 金额: $ 22.58万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-09-30 至 1992-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371957
• 关键词: AIDS; clinical trials; critical care; ethics; extended care; health care facility; health care personnel; health care professional practice; health related legal; home for elderly; institutional care facility; interview; mental disorders; nursing homes; patient care planning; preference; terminal patient care

This study aims to measure the validity and reliability of patient preferences for life-sustaining treatment and states near to or worse than death. This information is needed to assess the potential validity and reliability of advance directives for medical care, such as living wills. Specifically, we will identify the medical interventions, and health and social states which form the domain of content for advance directives, as well as the factors which influence the acceptability of advance directives. We will also evaluate the construct validity test- retest reliability, and internal consistency of patient treatment preferences, and the ability of patients to predict their preferences for states and interventions they have not previously experienced (predictive validity). This study has three phases. In Phase I, 50 patients, 10 well-adults, 15 physicians, and 15 nurses will receive a semi- structured interview to identify the relevant content for advance directives and to pretest methods for Phase II. In Phase II, 250 patients and 100 well adults will be administered a structured interview to scale their preferences for states and medical interventions, and evaluate the construct validity, predictive validity, and internal consistency of their preferences. In Phase III, patients, and well-adults will be reinterviewed two weeks and six months following their enrollment in Phase II to evaluate the test- retest reliability and predictive validity, respectively, of their preferences. Patients will include persons with acquired immunodeficiency syndrome, terminal illness, elderly with chronic disease, cognitively impaired, and nursing home residents. Physicians will be selected from a variety of primary care and subspecialty practices. Nurses will be selected from intensive care, inpatient, outpatient, home health, and nursing home practices. These results will be directly applicable to the development of valid, efficacious, and effective advance care directives. In addition, they will provide an improved basis for understanding the validity and reliability of preferences contained in advance directives.

本研究旨在测量患者的信度和效度。 对维持生命治疗的偏好和接近或更差的状态 而不是死亡。这些信息是评估潜在有效性所必需的。 以及对生活等医疗保健的预先指示的可靠性 威尔斯。具体来说，我们将确定医疗干预措施，以及 构成先进内容领域的健康和社会状态 指令以及影响可接受性的因素 先行指令。我们还将评估结构效度测试- 患者治疗的重测信度和内部一致性 偏好，以及患者预测他们的偏好的能力 他们以前从未经历过的国家和干预措施(预测性 有效性)。 这项研究分为三个阶段。在第一阶段，50名患者，10名健康成年人，15名 医生和15名护士将接受半结构化面试 确定先行指令的相关内容并进行预试 第二阶段。在第二阶段，250名患者和100名健康的成年人将 组织一次有组织的面谈，以衡量他们对 状态和医学干预，并评估结构效度， 预测效度，以及他们偏好的内部一致性。在……里面 第三阶段，患者和健康成年人将在两周内重新面谈 在他们参加第二阶段评估测试的六个月后- 重测信度和预测效度分别为 偏好。患者将包括获得性免疫缺陷患者。 认知上的综合征、绝症、老年慢性病 残障人士和疗养院居民。医生将从以下人员中挑选 各种初级保健和专科实践。护士们将成为 从重症监护、住院、门诊、家庭健康和 疗养院的实践。 这些结果将直接适用于开发有效的、 有效的、有效的预先护理指令。此外，他们还 将提供更好的基础来理解有效性和 预先指令中包含的偏好的可靠性。