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Impact of patients’ expressed wishes on their surrogate decision makers’ preferred decision-making roles in Japan
http://hdl.handle.net/10271/00003505
http://hdl.handle.net/10271/000035050e69cb68-ad63-491f-aa58-25b7a693b6ee
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
論文本文 (593.0 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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| 公開日 | 2019-02-21 | |||||
| タイトル | ||||||
| タイトル | Impact of patients’ expressed wishes on their surrogate decision makers’ preferred decision-making roles in Japan | |||||
| 言語 | en | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||
| 資源タイプ | doctoral thesis | |||||
| アクセス権 | ||||||
| アクセス権 | open access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
| その他のタイトル | ||||||
| その他のタイトル | 日本での、代理意思決定者の意思決定において希望する役割へ、患者の意思表示が与える影響 | |||||
| 言語 | ja | |||||
| 著者 |
津田, 修治
× 津田, 修治 |
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| 書誌情報 |
en : Journal of Palliative Medicine 巻 21, 号 3, p. 354-360, 発行日 2018-03-01 |
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| 出版者 | ||||||
| 出版者 | Mary Ann Liebert | |||||
| 言語 | en | |||||
| 権利 | ||||||
| 言語 | en | |||||
| 権利情報 | Final publication is available from Mary Ann Liebert,Inc. : http://dx.doi.org/10.1089/jpm.2017.0226 | |||||
| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | Background: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. Objective: We investigated the decision readiness of HMC patients and their family surrogates. Design: Cross-sectional survey. Setting/Subjects: We collected data from dyads consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016. Measurements: Surrogates completed a questionnaire on their sociodemographic and health status and their decision readiness. Primary HMC physicians provided information on their patients. Results: A total of 337 dyads were screened, and 159 were included. The mean age of patients and surrogates was 86 and 64 years respectively, and 29% of patients were cognitively impaired. Only 1.9% of the patients left written advance directives, and 32% were entrusting all decision-making to the doctor or their families. Regarding the surrogate's preferred decision-making role, 21.9% of the surrogates preferred doctors to assume decision-making responsibility. A multivariate analysis revealed that no discussion of care goals (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.02-8.17) and patients having expressed their wishes verbally, including entrusting decision making to others (OR 2.51, 95% CI 1.07-5.89), were associated with surrogates' preference for doctors to have decision-making responsibility. Conclusions: Many patients preferred to entrust the end-of-life decisions to others rather than utilizing advance directives, which made surrogates more dependent on doctors for decision making. Qualified advance care planning is required to promote familial discussion and surrogates' decision readiness. |
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| 言語 | en | |||||
| 学位名 | ||||||
| 言語 | ja | |||||
| 学位名 | 博士（医学） | |||||
| 学位の区分 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | doctoral | |||||
| 言語 | en | |||||
| 学位の分野 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 医学系研究科 | |||||
| 言語 | ja | |||||
| 学位授与機関 | ||||||
| 学位授与機関識別子Scheme | kakenhi | |||||
| 学位授与機関識別子 | 13802 | |||||
| 言語 | ja | |||||
| 学位授与機関名 | 浜松医科大学 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 2018-03-13 | |||||
| 学位授与番号 | ||||||
| 学位授与番号 | 甲第786号 | |||||
| ISSN | ||||||
| 収録物識別子タイプ | PISSN | |||||
| 収録物識別子 | 1096-6218 | |||||
| EISSN | ||||||
| 収録物識別子タイプ | EISSN | |||||
| 収録物識別子 | 1557-7740 | |||||
| PubMed番号 | ||||||
| 識別子タイプ | PMID | |||||
| 関連識別子 | 29148907 | |||||
| 出版社DOI | ||||||
| 識別子タイプ | DOI | |||||
| 関連識別子 | https://doi.org/10.1089/jpm.2017.0226 | |||||
| 著者版フラグ | ||||||
| 出版タイプ | AM | |||||
| 出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
