住院病患家屬對病人自主權利法的認知、態度及預立醫療決定的行為意向

吳佳穎; 陳端容; 黃心慈

doi:10.6288/TJPH.202006_39(3).109041

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P342 - 349

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6288/TJPH

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住院病患家属对病人自主权利法的认知、态度及预立医疗决定的行为意向

Knowledge and attitudes regarding the Patient Autonomy Act and behavioral intention regarding signing advance decision among in-patients' family members

吴佳颖(Chia-Ying Wu) ；陈端容(Duan-Rung Chen) ；黄心慈(Shin-Tsyr Hung)

台湾公共卫生杂志； 39 卷 3 期 (2020 / 06 / 15) ， P342 - 349

繁体中文 DOI： 10.6288/TJPH.202006_39(3).109041

病人自主权利法；住院患者家属；疾病末期；预立医疗决定行为意向； Patient Autonomy Act ； in-patients' family members ； terminal illness ； behavioral intention of advance decision

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摘要 │ 参考文献 (25) │ 被引用文献 (9) │ 国际计量

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Objectives: To investigate the understanding of and attitude toward the ＂Patient Right to Autonomy Act＂ (hereafter, Patient Autonomy Act) among family members of hospitalized patients and their behavioral intention in advance decision (AD). Methods: A structured and specifically tailored questionnaire was used to conduct interviews with 80 family members of patients in the intensive care unit, medical, and surgical wards of a national university hospital in Taipei. Results: (1) Only 49.8% of the interviewees were aware of the Patient Autonomy Act; however, the understanding of its content was very high, with a correct rate of 71.88%. The results indicated that most interviewees were in favor of the concept of patient autonomy. However, most interviewees were also unclear regarding the difference between the Patient Autonomy Act and euthanasia (assisted death). Women had a better grasp of this distinction than did men (correct rate = 35.00% vs. 13.75%). Married individuals demonstrated a better understanding of the Patient Autonomy Act than unmarried individuals did. (2) More than 90% of the interviewees were willing to engage in advance care planning; however, only 51.25% of the interviewees were willing to sign an AD. Interviewees who judged that they had a good quality of health were more inclined to sign an AD. (3) In case of terminal illness, interviewees' medical decisions were primarily concerned with whether the patient recovers consciousness after treatment, whether they were still able to move autonomously, and whether treatment would incur a financial burden. However, interviewees' medical decisions varied depending on whether the decision was to be taken in connection with themselves, their parents, or their spouses. (4) Notably, most of the interviewees did not think that after signing the Patient Autonomy Act, the medical staff would stop providing treatment or care, nor did they think that signing it was equivalent to simply waiting for death. Conclusions: Although family members of hospitalized patients do not fully understand the Patient Autonomy Act, most of them comprehend that the legislation respects ＂the treatment wishes of individuals.＂ Therefore, a large proportion of the population is in favor of the concept of individual autonomy. When confronted with their own terminal illness, Taiwanese people adopt different medical decisions than when faced with that of a parent or a spouse. This indicates that the government should strengthen awareness of AD, thereby avoiding decision-making quandaries in cases of terminal illness.

参考文献 ( 25 ) 〈TOP〉

全国法规资料库：病人自主权利法。https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=L0020189。引用2020/04/15。Laws & Regulations Database of the Republic of Chin. Patient Right to Autonomy Act. Available at: https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=L0020189. Accessed April 15, 2020.
Brown, BA(2003).The history of advance directives a literature review.J Gerontol Nurs,29,4-14.
Chan, CWH,Wong, MMH,Choi, KC(2019).Prevalence, perception, and predictors of advance directives among Hong Kong Chinese: a population-based survey.Int J Environ Res Public Health,16,365.
Cugliari, AM,Miller, T,Sobal, J(1995).Factors promoting completion of advance directives in the hospital.Arch Intern Med,155,1893-1898.
Despreaux, M,Coughlin, D,Drickamer, M(1996).Discussing advance directives: a study of outpatients’ attitudes.J Gen Intern Med,11,114.

被引用文献 ( 9 ) 〈TOP〉

萧雅竹,赵秀琴,温明达,黄翠媛(2023)。社区民众对於预立医疗决定行为意向及其相关因素之探讨。护理杂志，70(3)，54-65。
杨惠卿(2022)。後疫情时代探讨病人自主权利法对个人与家庭心理的影响。辅导季刊，58(3)，33-42。
杨启正,杨君宜,许家祯,纪郁君,周庭筠,李沂蓁,吴晓闻(2021)。20-35岁青年族群与全体意愿人参与预立医疗照护谘商概况比较：次级资料分析。安宁疗护杂志，26(1)，18-39。
杨启正,杨君宜,许家祯,李沂蓁,吴晓闻(2021)。探讨台北市签署预立医疗决定意愿人之区域特性。安宁疗护杂志，25(3)，205-222。
(2024)。高龄者对预立医疗自主计画之态度研究－以社区照顾关怀据点为例。社会发展研究学刊，34，92-120。

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