以家庭为中心的预立医疗照护计划在肿瘤终末期患者中的应用研究

Study on Application of Family-Centered Advance Care Planning in Patients with End-Stage Cancer

目的探讨以家庭为中心的预立医疗照护计划在肿瘤终末期患者中的应用效果。方法选取某三级甲等医院肿瘤终末期患者82例,按随机数字表法分为试验组和对照组各41例。对照组实施常规护理,试验组在对照组基础上实施以家庭为中心的预立医疗照护计划。比较两组维持生命治疗态度、临终照护意愿、生命意义感和尊严感的变化。结果干预后试验组患者对心肺复苏、人工辅助呼吸、尽可能延续生命措施的接受比例较对照组低,差异有统计学意义(p<0.05);干预后试验组患者生命意义感、尊严感显著优于对照组(p<0.05)。结论实施以家庭为中心的预立医疗照护计划可协助肿瘤终末期患者转变其维持生命治疗态度及临终照护意愿,提升其生命意义感与尊严感。

Objective To explore the effect of family-centered advance care planning among patients with end-stage cancer.Methods A total of 82 patients with end-stage cancer in a tertiary hospital were randomly divided into experimental group and control group,with 41 cases in each group.The control group carried out routine nursing,and the experimental group implemented family-centered advance care planning on the basis of the control group.The changes of attitude towards lifesustaining treatment,willingness of end-of-life care,meaning of life and dignity were compared between the two groups.Results After the intervention,the acceptance rates of cardiopulmonary resuscitation,artificial assisted respiration and lifeprolonging measures of patients in the experimental group were lower than those in the control group,and the differences were statistically significant(p<0.05).After intervention,the sense of meaning in life and dignity of patients in the experimental group were significantly better than those in the control group(p<0.05).Conclusion The family-centered advance care planning can effectively change their attitudes towards life-sustaining treatments and willingness of end-of-life care,enhance their sense of meaning in life and dignity.