病人对数码预设照顾指示的可用性与接受程度.pdf

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1、Digital Advance Care Planning for dialysis patientsDr Chetna MalhotraAssociate ProfessorResearch DirectorLien Centre for Palliative CareDuke-NUS Medical School SingaporeWhat is Advance care planning(ACP)?ACP is one of the most discussed interventions to promote EOL conversations.It enables understan

2、ding and sharing of values,goals,and preferences regarding current and future medical care.Goal of ACP is to Educate-Share-PrepareObjectives for ACP Educate-Share-Prepare1)Illness education Most patients do not understand enough about their illness and prognosis2)Elicitation of values and goals to g

3、uide current decisions This allows them to engage in shared decision making.As goals change,ACP conversations need to be a continuous process3)Prepare for future end-of-life decisionsPreparation rather than planning is an objective3Public perspective:Uptake of ACP is lowe.g.Singapore:Lack of readine

4、ss to engage in ACP among general public.Positive attitude(n=262)Ready to sign official papers putting your wishes in writing about the kind of medical care you would want if you were near the end of life9.9%Ready to speak with your Healthcare Professional about the kind of medical care you would wa

5、nt if you were near the end of life8.8%Ready to speak with your Nominated Healthcare Spokesperson about the kind of medical care you would want if you were near the end of life11.1%Ready to sign official papers naming a person or group of people to be your spokesperson or to make decisions for you15

6、.3%Low et al.BMC Palliative Care 2024 Conversations and documentations are time consuming Most conversations required multiple sessions,each taking an hour or more Procuring multiple signatures time-consuming Many ACP conversations are never documented or uploaded on the IT systemACP is very tedious