CAJ | 학술논문

目的：调查粤北地区某三级甲等医院医护人员、恶性肿瘤患者及家属对实施预立医疗照护计划的态度及影响因素。方法采用自行设计的问卷，调查本院210名医护人员、105名恶性肿瘤患者家属及103例恶性肿瘤患者对预立医疗照护计划的态度及影响因素。结果医护人员、家属及患者对预立医疗照护计划的认知率分别为16.7%、9.5%及6.8%；赞同实施率分别为85.7%、51.4%及88.3%。不同文化程度、宗教信仰、住院经历及丧亲原因的家属对预立医疗照护计划的态度差异有统计学意义（P＜0.05）。医护人员、家属及患者支持实施预立医疗照护计划原因不一，其中选择较多原因为疾病长期折磨、临终时应减轻痛苦等；不支持实施预立医疗照护计划的原因医护人员选择较多为没有法律支持、应救死扶伤，家属选择较多为伦理道德问题，患者选择较多为有事未了。结论不同地区医护人员、患者及家属对预立医疗照护计划认知程度可能不同，医护人员及患者对实施预立医疗照护计划态度较家属更认可和支持，多因素影响实施预立医疗照护计划态度，实施时需综合考虑社会道德观念及法律等问题。
목적：조사월북지구모삼급갑등의원의호인원、악성종류환자급가속대실시예립의료조호계화적태도급영향인소。방법채용자행설계적문권，조사본원210명의호인원、105명악성종류환자가속급103례악성종류환자대예립의료조호계화적태도급영향인소。결과의호인원、가속급환자대예립의료조호계화적인지솔분별위16.7%、9.5%급6.8%；찬동실시솔분별위85.7%、51.4%급88.3%。불동문화정도、종교신앙、주원경력급상친원인적가속대예립의료조호계화적태도차이유통계학의의（P＜0.05）。의호인원、가속급환자지지실시예립의료조호계화원인불일，기중선택교다원인위질병장기절마、림종시응감경통고등；불지지실시예립의료조호계화적원인의호인원선택교다위몰유법률지지、응구사부상，가속선택교다위윤리도덕문제，환자선택교다위유사미료。결론불동지구의호인원、환자급가속대예립의료조호계화인지정도가능불동，의호인원급환자대실시예립의료조호계화태도교가속경인가화지지，다인소영향실시예립의료조호계화태도，실시시수종합고필사회도덕관념급법률등문제。
Objective To analyze the attitude of medical staff, patients and their families toward advance directives (AD) and its influence factors. Methods A total of 210 medical staff, 105 patients ’ families and 103 patients with malignant tumor were investigated with self-designed questionnaires about attitude toward AD and factors associated with the preference of AD. Results The ratio of AD cognition was 16.7%, 9.5% and 6.8% in medical staff, families and patients, respectively and that of implementation agreement was 85.7%, 51.4% and 88.3% respectively. The attitude toward implementation of AD was statistically significant in families with different educational background, religion and bereavement experience ( P<0.05). The reasons of implementation agreement from medical staff, patients and their families included patients ’ choice and no therapeutic significance, ect and that of disagreement no legal support and morality, ect. Conclusion The cognition on AD is different among medical staff, patients and their families from different regions and the attitude of medical staff and patients toward implementation is more positive than that of patients’ families. Since many factors affect the attitude toward implementation of AD, it is necessary to take social morality, ethics and law into consideration when implementing AD.