儿童预立医疗照护计划研究与实践进展

Research and Practice Progress in Pediatric Advance Care Planning

预立医疗照护计划(advance care planning,ACP)是儿童安宁疗护的重要组成部分,是优化儿童临终照护的关键所在。有效的ACP可以了解患儿及其家庭的临终偏好,为患儿提供符合本人意愿的医疗和照护服务。此外,ACP还可以改善家属丧亲后心理疾病的发生率和严重程度。目前,国内外在儿科领域的ACP实践均十分有限。成功的ACP需要包括敏感的谈话、循序渐进的过程以及以家庭为中心的方法。未来的研究应在我国文化背景下探索患儿及其家庭的临终阶段各维度需求、偏好和价值观。在中国文化背景下构建适用于我国患儿的ACP模式,并开发相关辅助文件。

Advance care planning(ACP)is an important part of pediatric palliative care,and it is the key to optimize pediatric end-of-life care.ACP can explore the preferences of children and their families and provide care accordingly.In addition,ACP can improve the incidence and severity of mental illness among bereaved parents.At present,ACP practice in pediatrics at home and abroad is confined.A successful ACP includes sensitive conversation,a progressive process and a family-centred approach.Future research should explore the end-of-life needs,preferences and values of children and their families in the context of Chinese culture.It is necessary to construct ACP model in the context of Chinese culture and draft relevant supporting documents.