TECHNOLOGY USE AND PROLONGING DYING IN OLDER ADULTS

老年人的技术使用和延长死亡

• 批准号: 6078644
• 负责人: SHARON R KAUFMAN
• 金额: $ 17.72万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6078644
• 关键词: attitude; behavioral /social science research tag; clinical research; decision making; family structure /dynamics; health services research tag; hospital patient care; human old age (65+); human subject; intubation; patient care personnel relations; quality of life; respirators; terminal patient care

The goal of this 4-year qualitative anthropological study is to describe and examine how death in the context of technology use is facilitated, managed, or staved off, and to learn the values and assumptions surrounding both life prolonging and palliative strategies in the hospital setting. The study will take place on four hospital units in one community hospital in Berkeley CA. This will be an empirical, ethnographic investigation based on the collection of data by interviews with physicians, nurses, patients, families, and other hospital personnel, and by participant-observation of health care team meetings and the daily routine on hospital wards. The study has six specific aims: 1) to provide a descriptive account of life support technology use, especially mechanical ventilation, to prolong life and/or the dying process among individuals age 40 and older; 2) to learn which aspects of the intubation, maintenance, and withdrawal of life support technology are considered problematic and why; 3) to learn how staff think about their role in using life-prolonging technologies; 4) to explore the experience for families of having a relative on life sustaining technologies; 5) to investigate how meanings and decisions regarding life- prolonging technologies are influenced by hospital routines; and 6) to examine the practices health professionals employ to avoid the use of mechanical ventilation or other life prolonging measures. Coding-based qualitative data analysis will be used: cross-sectional comparison, in order to describe discrete patterns of thought, opinion and practice; thematic analysis and the case study approach, to identify themes that emerge within specific cases; and frequencies of response, in which themes, categories, and other variables are generated. The interpretive goal is to examine why closing the gap between what health consumers say they want and what actually happens with advanced technologies is so difficult.

这项为期4年的定性人类学研究的目标是描述和研究技术使用背景下的死亡是如何促进，管理或避免的，并了解医院环境中延长生命和姑息策略的价值观和假设。 这项研究将在加州伯克利一家社区医院的四个医院单位进行。这将是一个经验性的，民族志调查的基础上收集的数据，通过采访医生，护士，病人，家属，和其他医院工作人员，并通过参与观察医疗团队会议和医院病房的日常工作。 该研究有六个具体目标：1）提供生命支持技术使用的描述性说明，特别是机械通气，以延长40岁及以上个体的生命和/或死亡过程; 2）了解生命支持技术的插管，维持和撤回的哪些方面被认为是有问题的，以及为什么; 3）了解员工如何看待他们在使用生命延续技术方面的作用; 4）探讨有亲属的家庭使用生命延续技术的经验; 5）探讨医院常规如何影响生命延长技术的意义和决策;以及6）检查卫生专业人员为避免使用机械通气或其他延长生命的措施而采用的做法。 将使用基于编码的定性数据分析：横截面比较，以描述思想、意见和实践的离散模式;主题分析和案例研究方法，以确定具体案例中出现的主题;以及答复频率，其中产生主题、类别和其他变量。 解释性的目标是研究为什么缩小健康消费者所说的他们想要的和先进技术实际发生的情况之间的差距是如此困难。