...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of Clinical Oncology >End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences.
【24h】

End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences.

机译：临终讨论，达到目标和临终时的痛苦：与偏好相一致的预测和接受护理的结果。

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE: Physicians have an ethical obligation to honor patients' values for care, including at the end of life (EOL). We sought to evaluate factors that help patients to receive care consistent with their preferences. METHODS: This was a longitudinal multi-institutional cohort study. We measured baseline preferences for life-extending versus symptom-directed care and actual EOL care received in 325 patients with advanced cancer. We also measured associated sociodemographic, health, and communication characteristics, including EOL discussions between patients and physicians. RESULTS: Preferences were assessed a median of 125 days before death. Overall, 68% of patients (220 of 325 patients) received EOL care consistent with baseline preferences. The proportion was slightly higher among patients who recognized they were terminally ill (74%, 90 of 121 patients; P = .05). Patients who recognized their terminal illness were more likely to prefer symptom-directed care (83%, 100 of 121 patients; v 66%, 127 of 191 patients; P = .003). However, some patients who were aware they were terminally ill wished to receive life-extending care (17%, 21 of 121 patients). Patients who reported having discussed their wishes for EOL care with a physician (39%, 125 of 322 patients) were more likely to receive care that was consistent with their preferences, both in the full sample (odds ratio [OR] = 2.26; P < .0001) and among patients who were aware they were terminally ill (OR = 3.94; P = .0005). Among patients who received no life-extending measures, physical distress was lower (mean score, 3.1 v 4.1; P = .03) among patients for whom such care was consistent with preferences. CONCLUSION: Patients with cancer are more likely to receive EOL care that is consistent with their preferences when they have had the opportunity to discuss their wishes for EOL care with a physician.
机译：目的：医师在道德上有义务尊重患者的护理价值观，包括生命尽头（EOL）。我们试图评估有助于患者根据自己的喜好接受护理的因素。方法：这是一项纵向的多机构队列研究。我们在325名晚期癌症患者中评估了延长寿命与症状导向治疗以及实际EOL护理的基线偏爱。我们还测量了相关的社会人口统计学，健康状况和沟通特征，包括患者和医生之间的EOL讨论。结果：偏好被评估为死亡前125天的中位数。总体而言，68％的患者（325名患者中的220名）接受了EOL护理，符合基线偏爱。在认识到他们是绝症的患者中，这一比例略高（74％，在121位患者中有90位; P = 0.05）。认识到自己患有绝症的患者更倾向于采用症状导向的护理（121位患者中的100％为83％; 191位患者中的127位患者为66％; P = 0.003）。但是，一些意识到自己身患绝症的患者希望接受延长生命的护理（17％，121位患者中的21位）。报告与医生讨论过对他们的EOL护理愿望的患者（39％，322名患者中的125名）在全部样本中更有可能接受与他们的喜好相符的护理（优势比[OR] = 2.26; P <.0001），并且在意识到自己患有绝症的患者中（OR = 3.94; P = .0005）。在没有采取延长生命措施的患者中，身体不适的患者（平均得分，3.1 vs 4.1; P = .03）在这种护理与偏爱相一致的患者中较低。结论：癌症患者有机会与医生讨论其对EOL护理的意愿时，他们更有可能接受与他们的喜好相符的EOL护理。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号