PDF(Pubmed)
Abstract：
BACKGROUND: Advance directives (ADs) has recently been considered as an important component of palliative care for patients with advanced cancer and is a legally binding directive regarding a person\'s future medical care. It is used when a person is unable to participate in the decision-making process about their own care. Therefore, the present systematic review investigated the factors related to ADs from the perspective of cancer patients.
METHODS: A systematic review study was searched in four scientific databases: PubMed, Medline, Scopus, Web of Science, and ProQuest using with related keywords and without date restrictions. The quality of the studies was assessed using the Hawker criterion. The research papers were analyzed as directed content analysis based on the theory of planned behavior.
RESULTS: Out of 5900 research papers found, 22 were included in the study. The perspectives of 9061 cancer patients were investigated, of whom 4347 were men and 4714 were women. The mean ± SD of the patients\' age was 62.04 ± 6.44. According to TPB, factors affecting ADs were categorized into four categories, including attitude, subjective norm, perceived behavioral control, and external factors affecting the model. The attitude category includes two subcategories: \"Lack of knowledge of the ADs concept\" and \"Previous experience of the disease\", the subjective norm category includes three subcategories: \"Social support and interaction with family\", \"Respecting the patient\'s wishes\" and \"EOL care choices\". Also, the category of perceived control behavior was categorized into two sub-categories: \"Decision-making\" and \"Access to the healthcare system\", as well as external factors affecting the model, including \"socio-demographic characteristics\".
CONCLUSIONS: The studies indicate that attention to EOL care and the wishes of patients regarding receiving medical care and preservation of human dignity, the importance of facilitating open communication between patients and their families, and different perspectives on providing information, communicating bad news and making decisions require culturally sensitive approaches. Finally, the training of cancer care professionals in the palliative care practice, promoting the participation of health care professionals in ADs activities and creating an AD-positive attitude should be strongly encouraged.
METHODS: A systematic review study was searched in four scientific databases: PubMed, Medline, Scopus, Web of Science, and ProQuest using with related keywords and without date restrictions. The quality of the studies was assessed using the Hawker criterion. The research papers were analyzed as directed content analysis based on the theory of planned behavior.
RESULTS: Out of 5900 research papers found, 22 were included in the study. The perspectives of 9061 cancer patients were investigated, of whom 4347 were men and 4714 were women. The mean ± SD of the patients\' age was 62.04 ± 6.44. According to TPB, factors affecting ADs were categorized into four categories, including attitude, subjective norm, perceived behavioral control, and external factors affecting the model. The attitude category includes two subcategories: \"Lack of knowledge of the ADs concept\" and \"Previous experience of the disease\", the subjective norm category includes three subcategories: \"Social support and interaction with family\", \"Respecting the patient\'s wishes\" and \"EOL care choices\". Also, the category of perceived control behavior was categorized into two sub-categories: \"Decision-making\" and \"Access to the healthcare system\", as well as external factors affecting the model, including \"socio-demographic characteristics\".
CONCLUSIONS: The studies indicate that attention to EOL care and the wishes of patients regarding receiving medical care and preservation of human dignity, the importance of facilitating open communication between patients and their families, and different perspectives on providing information, communicating bad news and making decisions require culturally sensitive approaches. Finally, the training of cancer care professionals in the palliative care practice, promoting the participation of health care professionals in ADs activities and creating an AD-positive attitude should be strongly encouraged.
摘要：
背景：预先指令（AD）最近被认为是晚期癌症患者姑息治疗的重要组成部分，并且是关于个人未来医疗护理的具有法律约束力的指令。当一个人无法参与有关自己护理的决策过程时使用。因此,本系统综述从癌症患者的角度调查了与ADs相关的因素。
方法：在四个科学数据库中搜索了一项系统综述研究：PubMed，Medline,Scopus,WebofScience,和ProQuest使用相关关键字，没有日期限制。使用Hawker标准评估研究的质量。研究论文被分析为基于计划行为理论的定向内容分析。
结果：在5900篇研究论文中发现，22人被纳入研究。调查了9061例癌症患者的观点，其中4347人是男性，4714人是女性。患者年龄的平均值±SD为62.04±6.44。根据TPB,影响广告的因素分为四类，包括态度,主观规范，感知行为控制，以及影响模型的外部因素。态度类别包括两个子类别：“缺乏对AD概念的了解”和“以前的疾病经验”，主观规范类别包括三个子类别：“社会支持和与家庭的互动”，“尊重患者的意愿”和“EOL护理选择”。此外，感知控制行为的类别分为两个子类别：“决策”和“进入医疗保健系统”，以及影响模型的外部因素，包括“社会人口统计特征”。
结论：研究表明，对EOL护理的关注以及患者在接受医疗护理和维护人类尊严方面的愿望，促进患者与其家人之间公开沟通的重要性，以及提供信息的不同观点，传达坏消息和做出决策需要文化敏感的方法。最后,在姑息治疗实践中培训癌症护理专业人员，应大力鼓励卫生保健专业人员参与AD活动并树立积极的态度。
方法：在四个科学数据库中搜索了一项系统综述研究：PubMed，Medline,Scopus,WebofScience,和ProQuest使用相关关键字，没有日期限制。使用Hawker标准评估研究的质量。研究论文被分析为基于计划行为理论的定向内容分析。
结果：在5900篇研究论文中发现，22人被纳入研究。调查了9061例癌症患者的观点，其中4347人是男性，4714人是女性。患者年龄的平均值±SD为62.04±6.44。根据TPB,影响广告的因素分为四类，包括态度,主观规范，感知行为控制，以及影响模型的外部因素。态度类别包括两个子类别：“缺乏对AD概念的了解”和“以前的疾病经验”，主观规范类别包括三个子类别：“社会支持和与家庭的互动”，“尊重患者的意愿”和“EOL护理选择”。此外，感知控制行为的类别分为两个子类别：“决策”和“进入医疗保健系统”，以及影响模型的外部因素，包括“社会人口统计特征”。
结论：研究表明，对EOL护理的关注以及患者在接受医疗护理和维护人类尊严方面的愿望，促进患者与其家人之间公开沟通的重要性，以及提供信息的不同观点，传达坏消息和做出决策需要文化敏感的方法。最后,在姑息治疗实践中培训癌症护理专业人员，应大力鼓励卫生保健专业人员参与AD活动并树立积极的态度。
