山西省老年住院患者生前预嘱认知度和接受度现状调查

Investigation on the current status of recognition and acceptance of living will in elderly inpatients in Shanxi Province

目的通过调查山西省老年住院患者对生前预嘱的认知度、接受度现状,分析是否愿意制定生前预嘱的相关因素,为探讨如何在山西省老年住院患者中推广生前预嘱提供依据。方法采用自制问卷对2017年1—12月山西省老年住院患者进行随机抽样调查,共收集411例老年住院患者有效问卷,收集内容包括一般社会学资料(年龄、性别、民族、宗教信仰、居住地、文化水平、职业、有无子女、有无配偶)、生前预嘱认知及是否愿意签署生前预嘱"我的五个愿望"文件。采用χ2检验和Logistic回归模型分析老年住院患者签署生前预嘱文件意愿的相关因素。结果山西省411例老年住院患者对生前预嘱的认知水平低(146例,35.5%),在一般资料中,文化水平和职业与老年住院患者对生前预嘱的认知水平相关(χ2=12.093、11.906,P=0.001、0.008);多元Logistic回归分析结果显示,与60~69岁年龄段相比,70~79岁(OR=0.592,95%CI:0.360~0.974)和80~89岁(OR=0.408,95%CI:0.238~0.701)的老年住院患者对签署生前预嘱文件持消极态度,城市(OR=2.293,95%CI:1.335~3.940)、医务工作者(OR=3.156,95%CI:1.419~7.020)和无子女的老年住院患者(OR=3.156,95%CI:1.287~7.740)较农村、其他职业(除外教师和公务员)以及有子女的老年住院患者更愿意提前签署生前预嘱文件。结论山西省老年住院患者对生前预嘱认知水平低,对提前签署"我的五个愿望"文件接受度差,为使其惠及大众,需加大在我省范围内的推广和普及。

Objective To analyze related factors for whether or not to make the living will by investigating the current status of recognition and acceptance of living will among elderly inpatients in Shanxi Province,in order to provide the evidence for promoting the living will in elderly hospitalized patients in Shanxi Province.Methods A questionnaire survey was conducted on elderly inpatients in Shanxi Province from January 2017 to December 2017,including general information(age,gender,ethnicity,religious belief,dwelling place,education and profession,children,spouse),awareness of living wills and willingness to sign documents of"My Five Wishes".The chi-square test and Logistic regression analysis were used to analyze the related factors for elderly inpatients'willingness to sign living will documents Results The 411 elderly inpatients in Shanxi Province had a low level of cognition of living will(146 cases,35.5%).In general socio-demographic characteristics,only education level and profession were related to the cognition of living will(χ2=12.093 and 11.906,P=0.001 and 0.008).Multivariate Logistic regression analysis showed that as compared with inpatients aged 60-69 years,inpatients aged 70-79 years(OR=0.592,95%CI:0.360~0.974,P=0.039)and 80-89 years(OR=0.408,95%CI:0.238~0.701,P=0.001)held a significantly negative attitude towards signing the living will documents.According to dwelling place,as compared with countryside,urban elderly inpatients were more willing to sign living will documents in advance(OR=2.293,95%CI:1.335~3.940,P=0.003).At the comparison of other occupations with medical workers,teachers(P=0.429),civil servants(P=0.068),only medical workers(OR=3.156,95%CI:1.419-7.020,P=0.005)were more willing to sign living will documents in advance.As comparing elderly inpatients with children,the childless elderly inpatients were more willing to sign living will documents in advance(OR=3.156,95%CI:1.287~7.740,P=0.012).Conclusions Elderly inpatients in Shanxi Province have a low level of cognition of living will and a poor acceptance of signing the document of"my five wishes"in advance.In order to benefit the public,we need to increase the promotion and popularization of signing documents of living will in our province.