What do renal health-care professionals in Singapore think of advance care planning for patients with end-stage renal disease?

被引:32
|
作者
Yee, Alethea [1 ]
Seow, Ying Ying [4 ]
Tan, Sze Huey
Goh, Cynthia [1 ,3 ]
Qu, Limin [1 ]
Lee, Grace [2 ]
机构
[1] Natl Canc Ctr, Dept Palliat Med, Singapore 169610, Singapore
[2] Singapore Soc Nephrol, Singapore, Singapore
[3] Duke NUS Grad Med Sch, Lien Ctr Palliat Care, Singapore, Singapore
[4] Khoo Teck Puat Hosp, Dept Renal Med, Singapore, Singapore
关键词
advance care planning; end-stage renal disease; renal healthcare professionals; QUALITY-OF-LIFE; SYMPTOM BURDEN; DIALYSIS; ATTITUDES; DISCUSSIONS; PREFERENCES; DIRECTIVES; DEATH;
D O I
10.1111/j.1440-1797.2010.01401.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aim: Previous studies have focused either on advance medical directives rather than advance care planning (ACP), or on patient's perspectives on ACP rather than those of the health-care providers. This study aimed to explore the knowledge, attitudes and experience of renal health-care professionals in Singapore on ACP for patients with end-stage renal failure. Methods: A 41-item questionnaire was distributed to physicians, nurses, medical social workers (MSW) and other allied health professionals working in renal units. The questionnaire had four sections: demographics of the respondents, knowledge of, attitudes to and experience with ACP. Results: Of a total of 620 survey forms, 562 were returned, giving a response rate of 90.6%. Medical social workers and physicians had higher knowledge scores than the rest. Of doctors and MSW, 82.4% and 100%, respectively, considered ACP discussions as part of their role, but only 37.1% of nurses and 38.1% of other allied health-care professionals thought likewise. Nurses appeared to be the least confident in conducting ACP discussions, and most fearful of upsetting patients and families. Medical social workers were the most confident. The main barriers for physicians appeared to be lack of time, concerns regarding family backlash and the perception that patients were not prepared to discuss ACP. Conclusion: Training of renal health-care professionals in ACP should aim to correct misunderstandings surrounding ACP, address potential barriers and impart communication skills. In particular, renal nurses will need encouragement to initiate discussions and be equipped with the skills to do so.
引用
收藏
页码:232 / 238
页数:7
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