以质量求发展，以服务铸品牌

Journal of Nursing ›› 2022, Vol. 29 ›› Issue (18): 12-17.doi: 10.16460/j.issn1008-9969.2022.18.012

Previous Articles     Next Articles

Influencing Factors of Decision-making for Palliative Care in Family Members of Elderly People

WU Xiao-fen1,2, WANG Li-jie1,2, WANG Ning1, SU Ting1,2, LI Xi-ran1,2, LIANG Jin1,2, WANG Shuang1,2, ZHANG Jia-yi1,2, HUANG Qiu-na3   

  1. 1. General Practice Center, the Seventh Affiliated Hospital, Southern Medical University, Foshan 528244 China;
    2. School of Nursing, Southern Medical University, Guangzhou 510515, China;
    3. Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan 528300, China;
  • Received:2022-06-29 Online:2022-10-11 Published:2022-10-11

PDF (PC)

316

Like

Abstract: Objective To understand the intention, considerations and influencing factors for palliative care in family members of elderly people. Methods We conducted a cross-sectional study involving 995 family members of elderly people through convenience sampling method. They were surveyed by using a self-designed general information questionnaire and the Questionnaire of Intention and Considerations in Decision-making for Palliative Care in family members of elderly people. Results A total of 927 family members (93.2%) reported that they would accept palliative care service when elderly people suffer from incurable disease or condition. Statistical analysis showed that female family members, whether there were medial staff in the family, members with experience in caring elderly people at terminal stage, and those knowing palliative care were more likely to choose palliative care services. Influence factors of decision-making included the willingness, age, living status and decision-making ability, the possibility of cure for the disease, advantage or disadvantage of different health plans, prognosis of elderly people, doctor's suggestions for palliative care, components of palliative care service, service effect, relevant laws and regulations and other family members' opinions and suggestions. Binary logistic regression analysis showed that the sex of family member, whether there were medial staff in the family or not and doctor's suggestions for palliative care were independent factors influencing family members' intention for palliative care. Conclusion Family members show positive intention to accept palliative care for elderly people in the future. Decision-making for palliative care of family members is influenced by sex, whether there were medial staff in the family or not and doctor's suggestion for palliative care, which provides implications for the construction of palliative care plan.

Key words: palliative care, elderly people, family member, decision-making intention, considerations in making decision, influencing factor

CLC Number: 

  • R48
[1] Government of Northwest Territories. Palliative Approach to Care Service Delivery Model for the NWT[EB/OL].[2022-06-24].https://www.hss.gov.nt.ca/sites/hss/files/resources/palliative-approach-care-service-deliv.
[2] Roth AR, Canedo AR.Introduction to Hospice and Palliative Care[J]. Prim Care, 2019,46(3):287-302. DOI:10.1016/j.pop.2019.04.001.
[3] World Health Organization.Definition of Palliative Care[EB/OL]. [2021-05-07].https://www.who.int/health-topics/palliative-care.
[4] 马红鸽, 席恒. 卫计委介入老年人临终关怀服务问题研究[J]. 西北大学学报(哲学社会科学版), 2016,46(2):159-164. DOI:10.16152/j.cnki.xdxbsk.2016-02-025.
[5] 李济时, 杨利, 景海曼, 等. 晚期肿瘤患者临终不抢救决策实施的回顾性分析[J].中国肿瘤临床与康复, 2018,25(11):1281-1283. DOI:10.13455/j.cnki.cjcor.2018.11.01.
[6] Scheinberg-Andrews C, Ganz FD.Israeli Nurses’ Palliative Care Knowledge, Attitudes, Behaviors, and Practices[J]. Oncol Nurs Forum, 2020,47(2):213-221. DOI:10.1188/20.ONF.213-221.
[7] 罗明琴, 潘世琴, 谢建芝, 等. 护理人员安宁疗护知识问卷的编制及信效度检验[J]. 护理学报, 2019,26(19): 35-39. DOI: 10.16460/j.issn1008-9969.2019.19.035.
[8] 倪延延, 张晋昕. 假设检验时样本含量估计中容许误差δ的合理选取[J]. 循证医学, 2011,11(6):370-372. DOI:10.3969/j.issn.1671-5144.2011.06.011.
[9] 徐嘉婕, 彭颖, 施永兴, 等. 上海市社区卫生服务中心安宁疗护服务提供和补偿研究[J]. 中国卫生经济, 2019,38(8):64-67. DOI:10.7664/CHE20190816.
[10] 王蒙蒙, 徐天梦, 岳鹏. 我国现行安宁疗护的相关政策梳理、挑战与建议[J]. 医学与哲学, 2020,41(14):19-22. DOI: 10.12014/j.issn.1002-0772.2020.14.04.
[11] Finkelstein EA, Bhadelia A, Goh C, et al.Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021[J]. J Pain Symptom Manage, 2021,63(4): e419-e429. DOI: 10.1016/j.jpainsymman.2021.12.015.
[12] World Health Organization. Integrating Palliative Care and Symptom Relief into Primary Health Care: A WHO Guide for Planners, Implementers and Managers[EB/OL]. (2018-10-16)[2021-9-13].https://www.who.int/publications/i/item/integrating-palliative-care-and-symptom-relief-into-primary-health-care.
[13] Cain CL, Surbone A, Elk R, et al.Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making[J]. J Pain Symptom Manage, 2018,55(5): 1408-1419. DOI: 10.1016/j.jpainsymman.2018.01.007.
[14] 徐洁,孙小茹,于莉,等. 癌症晚期病人家属临床决策影响因素分析[J]. 护理研究, 2019,33(18):3192-3197. DOI: 10.12102/j.issn.1009-6493.2019.18.024.
[15] 刘俊荣, 吴开, 谢汉春. 医疗决策模式与决策主体的选择倾向研究[J]. 医学与哲学, 2018,39(19):14-20. DOI:10.12014/j.issn.1002-0772.2018.10a.04.
[16] Vanbutsele G, Van Belle S, Surmont V, et al.The Effect of Early and Systematic Integration of Palliative Care in Oncology on Quality of Life and Health Care Use Near the End of Life: A Randomised Controlled Trial[J]. Eur J Cancer, 2020,124:186-193. DOI:10.1016/j.ejca.2019.11.009.
[17] 黄晓君, 梁金燕, 向洁. 国内重症监护病房临终患者救治选择影响因素定性研究的系统评价[J].护理实践与研究, 2021,18(7):999-1002.DOI:10.3969/j.issn.1672-9676.2021.07.013.
[18] 孙思涵. 儒家家庭主义视角下病危患者的生死抉择——由“琼瑶事件”引发的思考[J]. 中国医学伦理学, 2017,30(9):1114-1117.DOI:10.12026/j.issn.1001-8565.2017.09.12.
[19] Glajchen M, Goehring A, Johns H, et al.Family Meetings in Palliative Care: Benefits and Barriers[J]. Curr Treat Options Oncol, 2022,23(5): 658-667.DOI:10.1007/s11864-022-00957-1.
[20] 魏宁, 周绿林, 张磊. 中老年人口去世前一年医疗费用支出影响因素研究[J]. 卫生经济研究, 2017(6):27-29.
[21] Ning XH.Hospice and Palliative Care in Mainland China: History, Current Status and Challenges[J]. Chin Med Sci J, 2018,33(4):199-203. DOI:10.24920/003524.
[22] Family Caregiver Alliance.Caregiver Statistics: Demographics[EB/OL].[2022-07-21].https://www.caregiver.org/resource/caregiver-statistics-demographics/.
[23] Ullrich A, Grube K, Hlawatsch C, et al.Exploring the Gender Dimension of Problems and Needs of Patients Receiving Specialist Palliative Care in a German Palliative Care Unit - the Perspectives of Patients and Healthcare Professionals[J]. BMC Palliative Care, 2019,18(1):59. DOI: 10.1186/s12904-019-0440-7.
[24] 夏文芳. 医患共同决策临床实效的影响因素分析[J]. 医学与哲学, 2021,42(12):11-14. DOI:10.12014/j.issn.1002-0772.2021.12.03.
[25] 王思潼, 李丽. 基于移动医疗的患者决策辅助临床应用的影响因素[J]. 解放军护理杂志, 2019,36(12):83-85;89. DOI: 10.3969/j.issn.1008-9993.2019.12.022.
[1] YAN Wen-juan, LI Zhuang-miao, YU Meng-ting, LI Shi-en, CHI Yan-hong. Systematic Review of Influence Factors of Stigma in Stroke Patients [J]. Journal of Nursing, 2022, 29(8): 46-52.
[2] HU Hui-ju, GUO Xue-qi, TANG Qi-qun, CHENG Jie, LI Hui-yuan, LI Tian-tian. Mediating Effect of Cognition of Aging between Perceived Social Support and Inner Strength of the Elderly in Nursing Homes [J]. Journal of Nursing, 2022, 29(3): 57-61.
[3] WEI Yu-qi, WANG Rui-rui, YANG Xia, AN Cong-cong, YANG Ting, YANG Xue-shi, LIU Yan-hui. Current Status and Influencing Factors of Nicotine Dependence in Smoking Stroke Patients [J]. Journal of Nursing, 2022, 29(18): 1-5.
[4] LIU Kai-li, LUO Yan-yan, YAO Gui-ying, ZHU Zhi-ling, GUO Hua, DU Yi-shen, QIN Li-wei, WU Hui-min, LI Jia-bo. Translation of Palliative Care Attitudes Scale and Its Reliability and Validity [J]. Journal of Nursing, 2022, 29(16): 11-16.
[5] ZHENG Jun-jun, YU Wei-hua, YAN Ting. Current Status of Sedentary Behavior of the Elderly in Medical-nursing Combined Institutions and Its Influencing Factors [J]. Journal of Nursing, 2022, 29(15): 1-6.
[6] ZHANG Yun-fei, LUO Hui-yu, ZHU Hong-yu, LI Mao-lu, XU Zhen-hua, KE Xi. Current Status and Influencing Factors of Resourcefulness in Patients with Permanent Enterostomy [J]. Journal of Nursing, 2022, 29(14): 12-17.
[7] SHI zhao-wei, ZHANG Yang, GUAN Chang-rong, ZHENG Xiao-jia, CHEN Min-hua. Effect of Nutritional Intervention and Cooking Practice Education for Main Family Members on Management of Patients with Type 2 Diabetes Mellitus [J]. Journal of Nursing, 2021, 28(4): 73-76.
[8] ZHANG Jia-hui, PANG Shu-qin, LI Mian-li, GE Li, ZHENG Zhi-hui, HONG Xue-pei. Self-pension Provision of Pre-elderly People in Urban Community: A Qualitative Research [J]. Journal of Nursing, 2021, 28(24): 12-16.
[9] WANG Zhang-yi, ZHAO Hao-mei, WANG Yue, WANG Zhao, PANG Xiao-li. Status Quo of Cognition on Spiritual Care and Its Influence Factors in Nursing Students in Tianjin: A 2, 057-case Study [J]. Journal of Nursing, 2021, 28(18): 1-6.
[10] TANG He, QIAO Yu, ZHU Jia-mei, ZHANG Min. Cross-cultural Adaptation of Chinese Version of Questionnaire of Use of Sleep Medication in Elderly [J]. Journal of Nursing, 2021, 28(17): 11-14.
[11] WU Cheng-kai, XU jun, HUANG Chen, LIU Qian, LI Wen-yuan. Healthy Fitness of Elderly People in Guangzhou and Its Influence Factors [J]. Journal of Nursing, 2021, 28(17): 6-10.
[12] LIU Jin, LU Na, ZHANG Feng-wa, NIU Xiao-dan, YUAN Rong-jing, LI Wen-yan, WANG Ye-tong, WANG Yan-hong. Influence Factors of Cancer Recurrence Fear in Breast Cancer Patients：A Meta-analysis [J]. Journal of Nursing, 2021, 28(14): 1-7.
[13] ZHAO Guang-fang, XING Ai-hong, DAI Ling-yu, CHEN Hao, WU Yu-ling, ZHAO Hong-le, ZHANG Shu-xiang. Status Quo and Influence Factors of Vocational Nursing Students' Career Motivation for Gerontological Nursing [J]. Journal of Nursing, 2021, 28(10): 1-6.
[14] WU Yu-jie, XING Nai-jiao, HAN Li, LIU Pan-pan, ZHAO Di, ZHAO Meng-lu, WANG Ai-min. Risk Factors of Housebound Elderly in Community and Development of Risk Prediction Model [J]. Journal of Nursing, 2020, 27(8): 11-15.
[15] SONG Jie, QU Gui-yu, LIN Yun-ying, HOU Shan-shan, WU Bing-yi. Construction of Evaluation Index System for Safety Management of Elderly People in Nursing Home Integrating Pension Service with Medical Service [J]. Journal of Nursing, 2020, 27(2): 1-5.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!