210; Department of Geriatric Medicine, Alexandra Hospital, Singapore
關鍵詞
Buddhism and Medicine; Advance Directives; Attitude; Mongoloid Race; Terminal Care; Aged; Aged, 80 and Over; Ethnology in China; Cross-Sectional Studies; Decision Making; Middle Age; Physician-Patient Relations; Quality of Life; Singapore; Low, J. A.; Ng, W. C.; Yap, K. B.; Chan, K. M.; Public Health/Health Services and Medical Care; General Biology/Philosophy; General Biology/Institutions, Administration and Legislation; Social Biology; Human Ecology; Pathology, General and Miscellaneous/Necrosis; Cardiovascular System/General; Blood, Blood-Forming Organs and Body Fluids/General; Urinary System and External Secretions/General; Respiratory System/General; Routes of Immunization, Infection and Therapy; Public Health/Public Health Administration and Statistics; Hominidae; Public Health; Allied Medical Sciences; Epidemiology; Population Studies; Sociology; Buddhist; Singaporean; Taoist; Elderly; Female; Male; Patient; Artificial ventilation; Therapeutic method; Cardiopulmonary resuscitation; Intravenous hydration; Nasogastric feeding; Renal dialysis; Advanced Medical Directive Act; Living Will; Day care center; End-of-life issues: choices, preferences; Euthanasia; Medical ethics; Surrogate decision-maker: doctor, family member; Terminal illness full disclosure
摘要
This was an exploratory study that was intended to provide a descriptive analysis of the choices and preferences of a group of elderly Chinese subjects attending a day care centre in Singapore with regard to end-of-life issues. Materials and Methods：A semi-structured one-to-one interview was conducted to collect data from the subjects. Qualitative techniques were used to analyse the data. Results：Forty-three subjects were interviewed. The median age was 71 years. There were more women than men (58. 1% vs. 41. 9%). The predominant religion was Buddhism/Taoism. 83. 7% and 76. 7% of the subjects preferred to be told of the diagnosis and prognosis of a terminal illness, respectively. The person most preferred to reveal the diagnosis was the attending doctor (60. 5%). About 83. 7% of the subjects have never heard of the Advanced Medical Directive Act，while 37. 2% agreed that making an advanced directive would be necessary. Twenty-three (53. 5%) would choose the doctor，while 15 (34. 9%) would choose a family member as a surrogate decision-maker. Twenty-two (51. 2%) thought that euthanasia should be allowed，while 15 (34. 9%) disagreed. With regard to supportive measures at the end of life，67. 4% wanted cardiopulmonary resuscitation，62. 8% wanted artificial ventilation，55. 8% wanted nasogastric feeding，65. 1% wanted intravenous hydration and 41. 9% wanted renal dialysis. Conclusion：There is a need for closer communication between older persons and their carers with regard to end-of-life care. The attending doctor appears to have an important role in this respect.
