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| Title: | 20-35歲青年族群與全體意願人參與預立醫療照護諮商概況比較：次級資料分析
Comparison of Participation Experiences between 20-35 years old Young People and All Willing People in Advance Care Planning: A Secondary Data Analysis |
| Authors: | 楊啟正;李沂蓁;吳曉聞;周庭筠;紀郁君;楊君宜;許家禎
Yang, Chi-Cheng;Lee, Yi-Jhen;Wu, Hsiao-Wen;Chou, Ting-Yun;Chi, Yu-Chun;Yang, Chun-Yi;Hsu, Chia-Chen |
| Contributors: | 心理系 |
| Keywords: | 病人自主權利法;預立醫療照護諮商;預立醫療決定;青年族群
Patient Right to Autonomy Act;advance care planning;advance decision;young People |
| Date: | 2021-12 |
| Issue Date: | 2022-06-30 11:09:09 (UTC+8) |
| Abstract: | 病人自主權利法設立為保障民眾醫療自主以達尊嚴善終，自108年正式施行，簽署預立醫療決定（Advance Decision, AD）民眾多數集中在60歲以上，惟表達自身醫療抉擇的需要性與重要性，絕非僅存在中老年族群，故本研究藉由分析資料比較20-35歲青年族群與全體意願人接受預立醫療照護諮商（Advance Care Planning, ACP）的經驗，期能做為未來制定青年族群宣導策略之參照。本研究採次級資料分析法，分析2019全年度於臺灣北部某區域教學醫院各院區接受ACP意願人所填寫之文件內容，檢視不同年齡層與各變項間的關係，變項包括：來源別（本院病患與否或員／志工）、ACP方式別（進行是在醫院或社區居家）、性別、身分別（一般民眾或具有社福弱勢族群相關身分）、是否有指定醫療委任代理人（Health Care Agent, HCA）、是否有二等親參與、是否有照顧經驗、諮商動機，及預立醫療決定意向。結果發現青年族群意願人多數為女性、高比例二等親陪同參與ACP，及鮮少有照顧經驗。全體意願人女性比例高於男性與過去研究結果一致；二等親的參與，除法條規定更顯現家人決定文化的影響。預作生命安排與期待尊嚴善終是青年族群參與ACP的主因。疾病狀況能否保有意識清楚且具自主表達能力將影響青年族群的AD選擇，未來宣傳時可強化引導對個人自主權利的思考，提供充足資訊，協助增進青年族群的自我認知與覺察，理解參與ACP及簽署AD的益處。
The Patient Right to Autonomy Act was established to protect people`s medical autonomy to achieve a good death with dignity. It had been implemented in 2019. Most people who sign Advance Decision (AD) are over 60 years old; however, expressing the need and importance of one`s own medical decisions is certainly not happening in the middle-aged and elderly people only. Therefore, this study explored the experience of the 20-35-year-old youth group accepting Advance Care Planning (ACP), hoping to be used as a reference when formulating youth group advocacy strategies in the future. This study adopts the secondary data analysis method to examine the contents of the documents filled out by whom engages in ACP in the various branches of a regional teaching hospital in northern Taiwan in 2019, and examine the correlation between different age groups and various variables, including: source (patient or staff/volunteer of the hospital or not), ACP method (conducted in the hospital or community), gender, identity of social welfare, having Health Care Agent (HCA) or not, having second degree of kinship or not, having caring experience or not, motivation for consultation, and AD selections. The results found that the majority of young people who are likely to sign AD are females, a high proportion of second-class relatives accompanied to participate in ACP, and with few caring experience. The higher proportion of women is consistent with the results of past research; the participation of second-class relatives, besides the provisions of the law, shows the influence of the family`s decision-making culture, and the cost becomes a disadvantage of promoting ACP; in addition, having caring experience can strengthen the motivation to participate in ACP. The main concern for the youth community to participate in ACP is life prearrangement and expecting a good death with dignity. Whether the disease condition can maintain the consciousness and self-expression ability affects the young people`s choice of AD. In future publicity, the focus should be on thinking about personal autonomy, providing adequate information to help increase the self-awareness of young people, understanding the benefits of participation in ACP and AD. |
| Relation: | 安寧療護雜誌, 26(1), 18-39 |
| Data Type: | article |
| DOI 連結: | https://doi.org/10.6537/TJHPC.202112_26(1).02 |
| DOI: | 10.6537/TJHPC.202112_26(1).02 |
| Appears in Collections: | [心理學系] 期刊論文
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