Withdrawal of life support -: who should decide?: Differences in attitudes among the general public, nurses and physicians
Withdrawal of life support -: who should decide?: Differences in attitudes among the general public, nurses and physicians
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DOI：
10.1007/s001340050987
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发表时间：
1999-09-01
影响因子：
38.9
通讯作者：
Berggren, L
中科院分区：
文献类型：
--
作者：
Sjökvist, P;Nilstun, T;Berggren, L
目的：研究一般公众对谁应该决定生命支持的撤回的态度，并将这些态度与重症监护人员的态度进行比较。设计：全国范围的邮寄问卷调查。设置：瑞典。参与者：从瑞典人口登记册中随机挑选了1 196人，339名护士和121名医生从29个随机选择的重症监护病房（ICUs.Measurements和结果：受访者的回答有关的两个临床场景的问题：一个有意识和有能力的病人和一个无意识的病人。一般公众的回复率为64%，护士为86%，医生为88%。关于有能力的患者，48%的公众、31%的护士和8%的医生认为，是否继续呼吸机治疗的决定应由患者单独或与家人一起做出，而不需要医生。绝大多数医生（87%）希望自己单独或与患者或家属一起做出决定。对于无行为能力的病人，73%的公众和70%的护士主张由家属和医生共同做出决定。大多数的医生（61%）认为自己是唯一的决策者，只有5%的公众和20%的nurs.Conclusions支持的观点：虽然现有的瑞典指南建议，医生应该是唯一的决策者，一般公众赞成更多的病人和家庭的影响，决定撤回生命支持相比，重症监护医生。
Objective: To examine the attitudes of the general public regarding who should decide about the withdrawal of life support and to compare these attitudes with those of intensive care personnel.Design: Nationwide postal questionnaire survey.Setting: Sweden.Participants: One thousand one hundred ninety-six randomly selected persons from the Swedish population register, 339 nurses and 121 physicians from 29 randomly selected intensive care units (ICUs).Measurements and results: Respondents' answers to questions related to two clinical scenarios: one with a conscious and competent patient and one with an unconscious patient. The response rates were 64 % for the general public, 86 % for the nurses and 88 % for the physicians. Concerning the competent patient, 48 % of the public, 31 % of the nurses and 8 % of the physicians were of the opinion that a decision about continued ventilator treatment should be made by the patient alone or together with the family, but without the physician. The vast majority of physicians (87 %) wanted to make the decision themselves, either alone or together with the patient or family. Concerning the incompetent patient, 73 % of the general public and 70 % of the nurses advocated a joint decision made by the family and the physician together. The majority of the physicians (61 %) regarded themselves as the sole decision-maker, a view supported by only 5 % of the public and 20 % of the nurses.Conclusions: While existing Swedish guidelines recommend that the physician should be the sole decisionmaker, the general public favour more patient and family influence on the decision to withdraw life support as compared with intensive care physicians.