PDF(Pubmed)
Abstract：
BACKGROUND: Advance Directive documents allow citizens to choose the treatments they want for end-of-life care without considering therapeutic futility.
OBJECTIVE: To analyze patients\' and caregivers\' answers to Advance Directives and understand their expectations regarding their decisions.
METHODS: This study analyzed participants\' answers to a previously published trial, conceived to test the document\'s efficacy as a communication tool.
METHODS: Sixty palliative patients and 60 caregivers (n = 120) registered their preferences in the Advance Directive document and expressed their expectations regarding whether to receive the chosen treatments.
RESULTS: In the patient and caregiver groups, 30% and 23.3% wanted to receive cardiorespiratory resuscitation; 23.3% and 25% wanted to receive artificial organ support; and 40% and 35% chose to receive artificial feeding and hydration, respectively. The participants ignored the concept of therapeutic futility and expected to receive invasive treatments. The concept of therapeutic futility should be addressed and discussed with both the patients and caregivers. Legal Advanced Directive documents should be made clear to reduce misinterpretations and potential legal conflicts.
CONCLUSIONS: The authors suggest that all citizens should be clarified regarding the futility concept before filling out the Advance Directives and propose a grammatical change in the document, replacing the phrase \"Health Care to Receive / Not to Receive\" with the sentence \"Health Care to Accept / Refuse\" so that patients cannot demand treatments, but instead accept or refuse the proposed therapeutic plans.
BACKGROUND: ClinicalTrials.gov ID NCT05090072.
UNASSIGNED: https://clinicaltrials.gov/ct2/show/NCT05090072.
OBJECTIVE: To analyze patients\' and caregivers\' answers to Advance Directives and understand their expectations regarding their decisions.
METHODS: This study analyzed participants\' answers to a previously published trial, conceived to test the document\'s efficacy as a communication tool.
METHODS: Sixty palliative patients and 60 caregivers (n = 120) registered their preferences in the Advance Directive document and expressed their expectations regarding whether to receive the chosen treatments.
RESULTS: In the patient and caregiver groups, 30% and 23.3% wanted to receive cardiorespiratory resuscitation; 23.3% and 25% wanted to receive artificial organ support; and 40% and 35% chose to receive artificial feeding and hydration, respectively. The participants ignored the concept of therapeutic futility and expected to receive invasive treatments. The concept of therapeutic futility should be addressed and discussed with both the patients and caregivers. Legal Advanced Directive documents should be made clear to reduce misinterpretations and potential legal conflicts.
CONCLUSIONS: The authors suggest that all citizens should be clarified regarding the futility concept before filling out the Advance Directives and propose a grammatical change in the document, replacing the phrase \"Health Care to Receive / Not to Receive\" with the sentence \"Health Care to Accept / Refuse\" so that patients cannot demand treatments, but instead accept or refuse the proposed therapeutic plans.
BACKGROUND: ClinicalTrials.gov ID NCT05090072.
UNASSIGNED: https://clinicaltrials.gov/ct2/show/NCT05090072.
摘要：
背景：高级指令文件允许公民选择他们想要的治疗方法进行临终关怀，而不考虑治疗无效。
目的：分析患者和护理人员对预先指令的回答，并了解他们对决定的期望。
方法：这项研究分析了参与者对先前发表的试验的回答，设想测试文档作为通信工具的功效。
方法：60名姑息患者和60名看护者（n=120）在AdvanceDirective文件中登记了他们的偏好，并表达了他们对是否接受所选治疗的期望。
结果：在患者和护理人员组中，30%和23.3%希望接受心肺复苏;23.3%和25%希望接受人工器官支持;40%和35%选择接受人工喂养和补水,分别。参与者忽略了治疗无效的概念，并期望接受侵入性治疗。治疗无效的概念应与患者和护理人员讨论。应明确法律高级指令文件，以减少误解和潜在的法律冲突。
结论：作者建议，在填写预先指令之前，应澄清所有公民的徒劳概念，并在文件中提出语法更改，将短语“接受/拒绝接受的医疗保健”替换为“接受/拒绝的医疗保健”，这样患者就不能要求治疗，而是接受或拒绝拟议的治疗计划。
背景：ClinicalTrials.govIDNCT05090072。
■https://clinicaltrials.gov/ct2/show/NCT05090072。
目的：分析患者和护理人员对预先指令的回答，并了解他们对决定的期望。
方法：这项研究分析了参与者对先前发表的试验的回答，设想测试文档作为通信工具的功效。
方法：60名姑息患者和60名看护者（n=120）在AdvanceDirective文件中登记了他们的偏好，并表达了他们对是否接受所选治疗的期望。
结果：在患者和护理人员组中，30%和23.3%希望接受心肺复苏;23.3%和25%希望接受人工器官支持;40%和35%选择接受人工喂养和补水,分别。参与者忽略了治疗无效的概念，并期望接受侵入性治疗。治疗无效的概念应与患者和护理人员讨论。应明确法律高级指令文件，以减少误解和潜在的法律冲突。
结论：作者建议，在填写预先指令之前，应澄清所有公民的徒劳概念，并在文件中提出语法更改，将短语“接受/拒绝接受的医疗保健”替换为“接受/拒绝的医疗保健”，这样患者就不能要求治疗，而是接受或拒绝拟议的治疗计划。
背景：ClinicalTrials.govIDNCT05090072。
■https://clinicaltrials.gov/ct2/show/NCT05090072。
