肿瘤患者预立医疗照护计划的影响因素研究

The Study of Influencing Factors for Advance Directives of Cancer Patients

目的:探讨预立医疗照护计划的影响因素及其预期效果。方法:选取安徽某综合性医院晚期恶性肿瘤患者112名,通过自编的预立医疗照护计划的影响因素及预期效果问卷开展调查,对结果进行统计分析。结果:影响实施预立医疗照护计划的患者因素包括相关知识、心理负担、医患沟通障碍、与家属沟通障碍、死亡恐惧、权利意识淡薄、担心后续治疗、制度保障缺乏、签署时间10个方面,前3位的影响因素依次是担心后续治疗、死亡恐惧、心理负担;所有项目得均分在2.7分以上,属于中度影响及以上。结论:实施预立医疗照护计划需要针对肿瘤患者担心后续治疗、死亡恐惧、心理负担等方面开展工作,以此提高肿瘤患者的自主决定权,促进患者生活质量的提高,减少医患冲突和纠纷,减少肿瘤患者的经济负担和医疗资源的消耗。

ObjectiVe：To inVestigate influencing factors for adVance directiVes and the eXpected effects. Methods：112 cancer patients from a general hospital in Anhui proVince were selected for an inVestigation of influencing factors for adVance di-rectiVes and the eXpected results. The inVestigation was conducted by the questionnaire of influencing factors and the eXpected effect,with the results statistically analyzed. ResuIts：The influencing factors for the implementation of adVance directiVes of the patients included such ten items as releVant knowledge,psychological burden,patients ＆#39; communication disorders with doctors, doctors＆#39; communication disorders with the families of the patients,fear of death,weak consciousness of the rights,worry oVer the follow-up treatment,the lack of institutional guarantee,signing time of the adVance directiVes. The top three influencing factors were the worry oVer follow-up treatment,the fear of death and the psychological burden,with an aVerage score of 2. 7 points or more in all the items,influencing moderately or a little seVerely. ConcIusion：Implementation of adVance directiVes needs to cen-ter around the work in the follow-up treatment,the fear of death and the psychological burden of the patients,etc. in order to strengthen the patients＆#39; own discretion,to improVe their life quality,to reduce conflicts and disputes between the hospitals and the patients and to lessen the patients＆#39; eXpense burden and medical resource consumption.