美国跨学科安宁疗护临床医师在病人自我管理临终药物时的存在特征。

IF 2.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Todd D Becker, Denae J Gerasta, Grant Yoder, Daniel D Matlock, Elissa Kozlov, Stacy M Fischer, Karla T Washington
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引用次数: 0

摘要

背景:尽管在临终医疗援助(MAID)相关护理中出现了临床和学术焦点,但有限的数据表明,当患者自我管理药物以加速他们的死亡时,临终关怀临床医生的存在。目的:探讨(1)跨学科安宁疗护临床医师参与病人自我使用MAID药物的比例及相关因素。设计:对横断面调查数据进行探索性二次分析。背景/对象:美国跨学科安宁疗护临床医师报告允许的州和组织的MAID政策的便利样本。测量:我们通过频率和百分比评估了患者自我给药期间出现的样本比例。我们通过调整小样本偏差的多重逻辑回归分析,检验了个人、专业、组织和maid特定特征之间的相关性。结果:我们的样本包括100名安宁疗护医师、护士、社工和牧师。描述性结果显示,只有超过三分之一的样本曾经出现在患者自我管理MAID药物。回归结果表明,作为一名牧师和在政策允许完全参与MAID的临终关怀医院工作,每一个都与更大的曾经存在的几率显著相关。相反,除了提供临终关怀患者使用MAID相关的信息外,从未提供过临终关怀的患者,其存在的几率显著降低。结论:安宁疗护医师参与病人自我使用MAID药物似乎比较普遍,且与选择的专业、组织和MAID特异性特征有关。改进年度状态报告做法和扩大复制工作是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing Interdisciplinary U.S. Hospice Clinician Presence During Patient Self-Administration of Medical Aid in Dying Medication.

Background: Despite emerging as a clinical and scholarly focus in medical aid in dying (MAID)-related care, limited data exist to characterize hospice clinician presence while patients self-administer the medication to hasten their death. Objectives: To explore (1) the proportion and (2) correlates of interdisciplinary hospice clinician presence during patient self-administration of MAID medication. Design: Exploratory secondary analysis of cross-sectional survey data. Setting/Subjects: Convenience sample of interdisciplinary U.S. hospice clinicians reporting permissive state and organizational MAID policy. Measurements: We assessed the proportion of the sample ever having been present during patient self-administration of MAID medication via frequency and percentage. We examined personal, professional, organizational, and MAID-specific characteristics as correlates via multiple logistic regression analysis adjusted for small sample bias. Results: Our sample included 100 hospice physicians, nurses, social workers, and chaplains. Descriptive results revealed that just over one-third of the sample had ever been present during patient self-administration of MAID medication. Regression results indicated that being a chaplain and working for a hospice with a policy permitting full MAID participation were each significantly associated with greater odds of ever having been present. Conversely, never having provided end-of-life care beyond information provision related to a hospice patient's use of MAID was significantly associated with lower odds of ever having been present. Conclusions: Hospice clinician presence during patient self-administration of MAID medication appears relatively common and related to select professional, organizational, and MAID-specific characteristics. Improved annual state reporting practices and expanded replication efforts are warranted.

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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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