住院病人簽署預立醫療指示的意願及接受宣導的意向

Inpatients' Willingness on and Acceptance of Promotion for Signing of Advance Directives

林慧美(Hui-Mei Lin) ； 楊嘉玲(Chia-Ling Yang) ； 陳美妙(Mei-Miau Chen) ； 邱泰源(Tai-Yuan Chiu) ； 胡文郁(Wen-Yu Hu)

《安寧療護雜誌》 16卷3期 (2011/11) Pp. 281-295

https://doi.org/10.6537/TJHPC.2011.16(3).1

摘要

研究目的：臺灣安寧緩和醫療條例賦予民眾「預立醫療指示」的權力，但實際國人簽署醫療預立指示比率仍偏低，故本研究目的擬探討內外科病房住院病人，對未來簽署預立醫療指示的意願及接受宣導的意向與其相關因素。材料與方法：採橫斷式描述性研究，以自擬結構式問卷為調查工具，於台北某聯合醫院五家院區內外科病房，二十歲以上意識清楚住院病人為受訪對象。結果：本研究收集有效樣本數206 位內外科住院病人，受訪者對未來簽署「預立醫療指示」的意願：會簽署（52.0％）、不會簽署（15.5%）及難以抉擇（32.5%）。會簽署理由前三項為：「能無遺憾，安祥且有尊嚴死亡」（74.8%）、「避免家人做決定的痛苦」（68.2%）、「可給予執行自己意願的保障」（67.3%）；而不會簽署的理由前三項為：「對醫療狀況不是很瞭解」（43.8%）、「覺得忌諱，不想去考慮此事情」（34.4%）及「仍不是很瞭解預立醫療指示的內容」（34.4%）。71.9%住院病人希望預立醫療指示在臺灣推廣，並認為若要在醫院推廣，透過醫護人員主動說明、宣導短片及單張都是很好的方式。結論：住院病人對目前醫療狀況及現行預立醫療指示內容不瞭解，會影響到簽署的意願，建議透過醫療訊息有效的溝通，同時宣導預立醫療指示的觀念與內容，使其瞭解精神與內涵，進而提升簽署預立醫療指示之意願，本研究結果可以作為醫療院所推廣預立醫療指示參考。

關鍵字

預立醫療指示 ； 住院病人 ； 安寧緩和醫療

並列摘要

Research Objective: This research intends to understand inpatients' willingness on and acceptance of promotion for signing of advance directive. Expect to provide the reference for related policies about educating the public on their willingness to participate in terminal care. Material and Method: This research adopts the cross-selective descriptive study, and uses a structured questionnaire as the research tool. The interviewees selected for the said study involved clearly conscious inpatients above the age of twenty in the medical /surgical wards of fivehospital compounds belonging to the United Hospitals. Result: In this study, access to the surgical ward inpatients, the number of 206 valid samples The willingness of interviewees with regard to the signing of an advance directive: the percentage of those who will sign is 52.0%, the percentage of those who refuse to sign is 15.5% and those who are undecided accounts for 32.5%. The first three reasons for signing include: helping patients die with dignity and serenity. without regrets (74.8%), helping families avoid the pain of making decisions (68.2%), and giving inpatients the protection to carry out their own wishes (67.3%). The first three reasons why people don't want to sign are: they don't know much about the medical condition (43.8%), they think it is a taboo and don't want to think about it (34.4%), and they don't know much about the contents of the advance directives (34.4%). 71.9% of inpatients hope that advance directives can be carried out in Taiwan. They think it's a good way to carry it out during hospitalization done with a thorough explanation by medical personnels, promotion videos and leaflets. Conclusion: Inpatients don't know much about the current medical condition and the contents of the current medical advance directives, which influences their willingness to sign. It is suggested that the willingess to sign advance directives can be encouraged through effective communication and provision of medical information, and the promotion of opinions and contents of the advanced directives, in which inpatients can have a better understanding about the intent and connotation of advanced directives. Regard to improving the quality of caring for patients with terminal illness as the ultimate goal.

並列關鍵字

Advance Directives ； Inpatient ； Palliative Care