Experience of Advance Directives in a Hospice Center

نویسندگان

  • Bong Han Kong
  • Ho Jung An
  • Hyun Seon Kim
  • So-Young Ha
  • Il-Kyu Kim
  • Jung Eun Lee
  • Youn Jung Park
  • Yi-Jin Kang
  • Young Rye Kim
  • Hoon-Kyo Kim
چکیده

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Advance Directives Improve Patient Outcomes after Hospice Enrollment

Continued on Page 3 Patients who enter hospice with an advance directive (AD) already completed may have an enhanced hospice experience. Compared with patients who enroll without an AD, they have longer lengths of stay, are less likely to die in an inpatient setting, and are less likely to leave hospice voluntarily, according to a report published in the Journal of the American Geriatrics Socie...

متن کامل

Japanese citizens' attitude toward end‐of‐life care and advance directives: A qualitative study for members of medical cooperatives

Background Japanese citizens are interested in choosing their own end-of-life care, but few have created their own advance directive. This study examined changes among Japanese citizens' attitudes toward end-of-life care and advance directives and explored factors that affected these attitudes. Methods We conducted five focus groups with 48 participants in 2009 and 2010. All participants were...

متن کامل

Regional variation in the association between advance directives and end-of-life Medicare expenditures.

CONTEXT It is unclear if advance directives (living wills) are associated with end-of-life expenditures and treatments. OBJECTIVE To examine regional variation in the associations between treatment-limiting advance directive use, end-of-life Medicare expenditures, and use of palliative and intensive treatments. DESIGN, SETTING, AND PATIENTS Prospectively collected survey data from the Healt...

متن کامل

Advance directives in home health and hospice agencies: United States, 2007.

This report provides nationally representative data on policies, storage, and implementation of advance directives (ADs) in home health and hospice (HHH) agencies in the United States using the National Home and Hospice Care Survey. Federally mandated ADs policies were followed in >93% of all agencies. Nearly all agencies stored ADs in a file at the agency, but only half stored them at the pati...

متن کامل

End-of-life hospital costs in cancer patients: do advance directives or routes of hospital admission make a difference?

OBJECTIVE End-of-life cancer care is costly. The current study explored whether advance directives or route of hospital admission reduced cancer patients' terminal hospitalization costs. METHODS This single-institution study focused on solid tumor patients who died on an inpatient oncology service in 2008 and 2009. Patients' total costs were compared based on advance directives and route of h...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 30  شماره 

صفحات  -

تاریخ انتشار 2015