1392名养老院老人对生命维持治疗的态度及影响因素分析  

Analysis of attitude of 1392 elderly in geracomium toward life-sustaining treatment and its influencing factors

作　　者：倪平[1] 曾铁英[2] 夏莹[2] 周晶[1] 王朝希[1] 聂荣[1] 毛靖[1] 

机构地区：[1]华中科技大学同济医学院 [2]华中科技大学同济医学院附属同济医院

出　　处：《护理研究（中旬版）》2014年第10期3604-3607,共4页Chinese Nursing Researsh

基　　金：中央高校基本科研业务经费(华中科技大学自主创新基金)资助课题;编号:2012QN206

摘　　要：[目的]了解养老院老人对维持生命治疗的态度及其影响因素。[方法]对武汉市民政局注册的61家养老院中的1 392名老人进行调研,探讨人口学变量、生活质量、活动功能、慢性病状况等对生命维持治疗的影响。[结果]老年人累积疾病量表(CIRS)评分为(4.7 9±3.29)分,老年人生活质量量表(QOLC-E)均分为(3.17±0.51)分,生理性日常生活能力(P-ADL)总分为(20.64±4.46)分,工具性日常生活能力(I-ADL)总分为(13.68±4.73)分;45.8%的老人在病情严重不可逆转时选择生命维持治疗;生命维持治疗的影响因素为保险状况、自觉健康水平、生活质量、活动功能。[结论]拥有保险、自觉健康状况较好、生活质量较高、活动功能较好的老人倾向于选择生命维持治疗;疾病较重、教育程度较低、自觉健康状况较差的老人倾向于拒绝生命维持治疗。建议医护人员多与养老院老人沟通无效救治和尊严死的意义,提高老人临终生活质量。Objective:To know about the attitude of elderly in geracomium toward life-sustaining treatment and its influencing factors.Methods A total of 1392 elderly from 61 geracomiums registered in Civil Affairs Bureau in Wuhan City were investigated.To explore the influence of demographic variables,quality of life(QOLC-E),activities of daily living(I-ADL,P-ADL),chronic disease status(CIRS)on life-sustaining treatment.Results:The CIRS score of elderly was 4.79±3.29.The average score of QOLC-E was 3.17±0.51.The total score of P-ADL was 20.64±4.46.The total score of I-ADL was 13.68±4.73.And 45.8%of the elderly has chosen life-sustaining treatment when their illness was critical and irreversible.Influence factors of life-sustaining treatment included insurance status,self perceived health level,quality of life,and activity function.Conclusion:Elderly with good health insurance,perceived health status,better quality of life and activity functions tend to choose life-sustaining treatment.Otherwise,elderly of severe illness,low education level,poor self-perceived health status tend to refuse life maintenance therapy.It suggests that medical personnel should communicate with elderly in geracomium about the meaning of ineffective treatment and death with dignity and improve the quality of life of elderly at the end stage.

关 键 词：养老院 老年人 生命维持治疗 态度 影响因素 

分 类 号：R473.2[医药卫生—护理学]