终末期患者家属在预立医疗照护计划代理决策中的研究及评价  

Research on Family Members of Patients with End of Life in Agency Decision-making in Advance Care Planning

作　　者：缪佳芮 陈柳柳[2] 张江辉[2] 邱业银 邓仁丽[2] MIAO Jia-rui;CHEN Liu-liu;ZHANG Jiang-hui(Zhuhai Campus of Zunyi Medical University,Zhuhai 519041,China)

机构地区：[1]遵义医学院珠海校区,广东珠海519041 [2]遵义医学院第五附属(珠海)医院,广东珠海519100

出　　处：《医学与哲学（B）》2018年第6期75-78,90,共5页Medicine & Philosophy(B)

基　　金：2016年国家自然科学基金(71663064)

摘　　要：终末期患者家属在代理决策时,常会陷入决策困境,发生决策冲突,产生习得性无助、焦虑等负性情感。知晓终末期患者临终意愿是解决这一现状的关键,预立医疗照护计划则可以帮助家属知晓患者临终意愿,发挥家属的积极性,提高代理决策质量。但国内外对家属在预立医疗照护计划代理决策中的研究鲜有报道。本文将立足于中西方文化背景—伦理道德,从家属代理决策的感受、影响因素、内容一致性、知晓患者意愿途径等方面进行综述,为提高终末期患者家属代理决策质量、实现预立医疗照护计划本土化提供依据。Family members of patients with end of life often act as agency decision-making in this process.They often fall into the decision-making dilemma,make decision-making conflicts and produce negative emotions.Advance care planning can solve this problem,it is a communication process among physicians,patients and family members,with the purpose to know the patient＇s wishes and provide treatments that meet the patient＇s wishes.Foreign countries and China have few reports on this point.Therefore,this article which is based on the Chinese and Western cultural background-ethics,is conducted from the four aspects：feelings of the family agency decision-making,influencing factors,content consistency and the way to know the patient＇s wishes,summering the framework to help family members to make decisions and giving a reference for further study.

关 键 词：预立医疗照护计划 代理决策 家属 终末期患者 

分 类 号：R48[医药卫生—临床医学]