养老机构医护人员预立医疗照护计划实践现状及对策分析

Investigation on practice of advance care planning among medical staff working in elder care facilities:countermeasures

目的调查养老机构医护人员预立医疗照护计划实践现状并分析影响因素,探讨对策。方法便利选取重庆市主城9个行政区内15所养老机构的223名医护人员进行预立医疗照护计划知识、行为、行为阻碍因素的调查。结果养老机构医护人员预立医疗照护计划行为总分为(10.22±2.19)分,处于中等水平,预立医疗照护计划行为平均参与率为20.1%;阻碍预立医疗照护计划行为的首要因素是"临终老年人的治疗通常由家属的意见决定";预立医疗照护计划知识总分为(20.88±6.33)分,处于中下水平;预立医疗照护计划了解情况、推行意愿及知识总分影响医护人员预立医疗照护计划行为(均P<0.01)。结论养老机构医护人员预立医疗照护计划实践较少,应加强培训宣传,针对影响及阻碍因素制定应对策略,以促进养老机构预立医疗照护计划工作的顺利推行。

Objective To investigate the practice of advance care planning(ACP)among medical staff working in elder care facilities,and analyze the influencing factors and countermeasures.Methods Through convenient sampling method,223 medical staffers working in 15 elder care facilities in 9 administrative regions of Chongqing main urban areas were recruited to fill out questionnaires about ACP knowledge,practice and practice hindrance.Results The total score of ACP practice among the medical staffers working in elder care facilities was(10.22±2.19)points,which was at medium level.The average participation rate of ACP practice was 20.1%.The leading factor impeding ACP practice was"the treatment of the dying elderly was usually determined by the views of the family".The total score of ACP knowledge was(20.88±6.33)points,which was below medium level.Overall knowledge of ACP,ACP implementation intention and ACP knowledge scores affected ACP practice of the medical staff(P<0.01 for all).Conclusion ACP practice among medical staff working in elder care facilities is less satisfactory.It is necessary to ramp up the training and publicity of ACP,and formulate strategies according the influencing and hindering factors,so as to smooth implementation of ACP in elder care facilities.