MEASUREMENT OF PREFERENCES FOR LIFE-SUSTAINING TREATMENT

生命维持治疗偏好的衡量

• 批准号: 3371956
• 负责人: RICHARD F UHLMANN
• 金额: $ 25.97万
• 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/3371956
• 关键词: AIDS; 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.

本研究的目的是测量病人的信度和效度 偏好维持生命的治疗和接近或更差的状态 而不是死亡需要这些信息来评估潜在的有效性 和可靠性的预先指示的医疗保健，如生活 所意欲具体来说，我们将确定医疗干预措施， 健康和社会状况，形成了促进发展的内容领域 指令，以及影响可接受性的因素 预先指示我们还将评估结构效度测试- 重测信度和患者治疗的内部一致性 偏好，以及患者预测其偏好 他们以前没有经历过的状态和干预（预测 有效性）。 这项研究分三个阶段。在第一阶段，50名患者，10名健康成人，15名 医生和15名护士将接受半结构化面试， 确定预先指示的相关内容，并预先测试 第二阶段的方法。在第二阶段，250名患者和100名健康成人将 进行结构化面试，以衡量他们对以下方面的偏好： 国家和医疗干预，并评估结构效度， 预测有效性和他们偏好的内部一致性。在 第三阶段，患者和健康成人将在两周内重新接受采访， 在他们参加第二阶段的六个月后评估测试- 重测信度和预测效度，分别，他们的 喜好患者将包括获得性免疫缺陷患者 综合征，绝症，慢性病老人，认知 残疾人和养老院居民。医生将从一个 各种初级保健和专科实践。护士将 选自重症监护、住院、门诊、家庭健康，以及 护理之家的做法。 这些结果将直接适用于开发有效的， 有效的和有效的预先护理指令。此外他们 将为理解有效性提供更好的基础， 预先指示中所包含的偏好的可靠性。