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題名：老人與代理人對於末期醫療決策之一致性：系統性文獻回顧
書刊名：安寧療護
作者：柯莉珊／胡文郁
作者(外文)：Ke, Li-shan／Hu, Wen-yu
出版日期：2014
卷期：19:1
頁次：頁18-32
主題關鍵詞：老人；代理人；末期醫療決策；一致性；Congruence；The elderly；Surrogates；End-of-life decisions
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:19
  • 點閱點閱:46
研究目的：以文獻回顧方式探討老人與代理人（surrogates）對於末期醫療決策的一致性、分析影響一致性之因素，以及提供增進一致性之措施。研究方法：利用關鍵字搜尋發表於華藝線上圖書館、CINAHL、Medline和Cochrane Library等資料庫之文章。結果：在老人與代理人對於末期醫療決策的一致性方面，因不同的研究使用不同的研究工具，且都提供不同的情境和不同的醫療處置進行測量，以致於難以進行統合分析，但老人和代理人對於目前健康狀況，若面臨心臟停止跳動是否進行急救的一致性為56~88%。在影響老人與代理人對於末期醫療決策的一致性方面，不願意拖累他人（reluctance to burden others; RBO）、老人和代理人的關係型態、家庭衝突、親密關係的經驗和預立照護計畫（advance care planning; ACP）會影響其一致性。在增進老人和代理人間對於末期醫療決策一致性的措施方面，發現利用影片和價值指標可以促進ACP的討論，並增加老人和代理人間的一致性。結論：目前國內對於促進老人與代理人於末期醫療決策一致性之相關研究闕如，建議未來相關研究能考慮使用影片和價值指標促進ACP的討論，以增進老人和代理人間對於末期醫療決策之一致性。
Purpose: The study's purposes were to explore the congruence between the elderly and their surrogates about end-of-life decisions, to find the influencing factors affect the congruence, and to find the interventions to increase the congruence between the elderly and their surrogates concerning end-of-life decisions. Methods: Using keywords searched in MeSH, and then contributed to the strings to search articles published in Airiti Library, CINAHL, MEDLINE, and the Cochrane Library database. Results: The rate of congruence between the elderly and their surrogates about CPR in current health state was 56~88%. The reluctance to burden others (RBO), type of elder-proxy relationship, family conflict, experience in close relationships, and advance care planning (ACP) affected the congruence between the elderly and their surrogates concerning end-of-life decisions. Applying a video decision support tool and using value indicators into ACP discussion increased the congruence between the elderly and their surrogates concerning end-of-life decisions. Conclusions: There are few studies related with this issue in Taiwan. We suggest that video decision support tool and value indicators can be applied in clinical field to increase the congruence between the elderly and their surrogates concerning end-of-life decisions.
期刊論文
1.林慧美、楊嘉玲、陳美妙、邱泰源、胡文郁(20111100)。住院病人簽署預立醫療指示的意願及接受宣導的意向。安寧療護，16(3)，281-295。new window  延伸查詢new window
2.Parks, S. M.、Winter, L.、Santana, A. J.、Parker, B.、Diamond, J. J.、Rose, M.、Myers, R. E.(2011)。Family factors in end-of-life decision-making: Family conflict and proxy relationship。Journal of Palliative Medicine，14(2)，179-184。  new window
3.Yung, V. Y.、Walling, A. M.、Min, L. L.、Wenger, N. S.、Ganz, D. A.(2010)。Documentation of advance care planning for community-dwelling elders。Journal of Palliative Medicine，13(7)，861-867。  new window
4.Somogyi-Zalud, E.、Zhong, Z.、Hamel, M. B.、Lynn, J.(2002)。The use of life-sustaining treatments in hospitalized persons aged 80 and older。J Am Geriatr Soc，50(5)，930-934。  new window
5.Sauler, M.、Siegel, M. D.(2012)。The past, present, and future of advance directives as a guide to end-of-life decision making。Chest，141(1)，9-10。  new window
6.Seckler, A. B.、Meier, D. E.、Mulvihill, M.、Paris, B. E.(1991)。Substituted judgment: How accurate are proxy predictions?。Ann Intern Med，115(2)，92-98。  new window
7.Coppolino, M.、Ackerson, L.(2001)。Do surrogate decision makers provide accurate consent for intensive care research?。Chest，119，603-612。  new window
8.Shalowitz, David I.、Garrett-Mayer, Elizabeth、Wendler, David(2006)。The accuracy of surrogate decision makers: A systematic review。Archives of Internal Medicine，166(5)，493-497。  new window
9.Sharma, R. K.、Hughes, M. T.、Nolan, M. T.、Tudor, C.、Kub, J.、Terry, P. B.、Sulmasy, D. P.(2011)。Family understanding of seriously-ill patient preferences for family involvement in healthcare decision making。Journal of General Internal Medicine，26(8)，881-886。  new window
10.Uhlmann, R. F.、Pearlman, R. A.、Cain, K. C.(1988)。Physicians' and spouses' predictions of elderly patients' resuscitation preferences。J Gerontol，43(5)，15-21。  new window
11.Corke, C. F.、Lavery, J. F.、Gibson, A. M.(2005)。Choosing life support for suddenly severely ill elderly relatives。Critical Care and Resuscitation，7(2)，81-86。  new window
12.Foo, A. S.、Lee, T. W.、Soh, C. R.(2012)。Discrepancies in end-of- life decisions between elderly patients and their named surrogates。Ann Acad Med Singapore，41(4)，141-153。  new window
13.Ayalon, L.、Bachner, Y. G.、Dwolatzky, T.、Heinik, J.(2012)。Preferences for end-of-life treatment: Concordance between older adults with dementia or mild cognitive impairment and their spouses。Int Psychogeriatr，24(11)，1798-1804。  new window
14.Gerety, M. B.、Chiodo, L. K.、Kanten, D. N.、Tuley, M. R.、Cornell, J. E.(1993)。Medical treatment preferences of nursing home residents: Relationship to function and concordance with surrogate decision-makers。J Am Geriatr Soc，41(9)，953-960。  new window
15.Winter, L.、Parks, S. M.(2012)。The reluctance to burden others as a value in end-of-life decision making: A source of inaccuracy in substituted judgment。Journal of Health Psychology，17(2)，179-188。  new window
16.Turan, B.、Goldstein, M. K.、Garber, A. M.、Carstensen, L. L.(2011)。Knowing loved ones' end-of-life health care wishes: Attachment security predicts caregivers' accuracy。Health Psychol，30(6)，814-818。  new window
17.Schmid, B.、Allen, R. S.、Haley, P. P.、Decoster, J.(2010)。Family matters: Dyadic agreement in end-of-life medical decision making。Gerontologist，50(2)，226-237。  new window
18.Volandes, A. E.、Mitchell, S. L.、Gillick, M. R.、Chang, Y.、Paasche-Orlow, M. K.(2009)。Using video images to improve the accuracy of surrogate decision-making: A randomized controlled trial。J Am Med Dir Assoc，10(8)，575-580。  new window
19.Ditto, P. H.、Danks, J. H.、Smucker, W. D.(2001)。Advance directives as acts of communication: A randomized controlled trial。Arch Intern Med，161(3)，421-430。  new window
20.Matheis-Kraft, C.、Roberto, K. A.(1997)。Influence of a values discussion on congruence between elderly women and their families on critical health care decisions。J Women Aging，9(4)，5-22。  new window
其他
1.World Health Organization。Definition of an older or elderly person，http ://www. who. int/healthinfo/survey/agein gdefnolder/en。  new window
 
 
 
 
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