河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (12): 1452-1458.doi: 10.3969/j.issn.1007-3205.2024.12.016

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我国医务人员对于放弃有效治疗的态度——一项横断面研究

  

  1. 北京协和医学院人文和社会科学学院,北京 100005

  • 出版日期:2024-12-25 发布日期:2025-01-03
  • 作者简介:张乾坤(1999-),男,河南周口人,北京协和医学院人文和社会科学学院医学硕士研究生,从事人文医学研究。
  • 基金资助:
    中国科协战略发展部资助课题(2023P001RW001);中央高校基本科研业务费专项资金资助课题(3332023182)

Medical staff′s attitudes to withdrawal of effective treatment in China: A cross-sectional study

  1. School of Humanities and Social Sciences, Peking Union Medical College, Beijing 100005, China

  • Online:2024-12-25 Published:2025-01-03

摘要: 目的 了解我国医务人员对放弃有效治疗的态度,分析其影响因素。
方法 基于2023年医务人员从业状况调研项目,采用随机抽样方法,抽取我国东、中、西部医院进行调查,结合专家意见自主设计网络自填式调查问卷,共收回8 386份有效问卷。对采集的数据进行频数分布的描述性统计分析、不同特征医务人员对于放弃有效治疗态度的χ2检验和探求影响因素的二元Logistic回归分析。
结果 21.1%(1 769/8 386)的医务人员选择“会”答应患者监护人请求;不同性别、年龄、婚姻状况、最高学历、职务类别、职称、所在科室、医院类型等的医务人员对于“放弃有效治疗”态度的差异有统计学意义(P<0.05);66.5%医务人员视临床实践采取不同措施;二元Logistic回归分析结果显示,男性、研究生学历、医护人员、急诊科、非民营医院是医务人员选择“放弃有效治疗”的危险性因素,年龄44岁以上、工作满意度越高、患者信任度越高的医务人员,更大概率不会选择同意患者家属的“放弃有效治疗”请求(P<0.05)。
结论 深入开展放弃治疗相关政策法规及伦理研究,为终末期患者的生死抉择提供价值引领,制定放弃治疗的标准程序,探索医患共同决策的可行模式。


关键词: 停止治疗, 医务人员, 医患决策

Abstract: Objective To understand medical staff′s attitude to withdrawal of effective treatment in China, and to analyze its influencing factors. 
Methods Based on Medical Staff′s Employment Survey in 2023, random sampling was used to select hospitals in eastern, central and western China for investigation. A self-administered online questionnaire was designed based on expert opinions, and a total of 8 386 valid questionnaires were retrieved. The collected data were analyzed by descriptive statistics for frequency distribution, chi-square test for attitude of medical staff with different characteristics towards withdrawal of effective treatment, and binary logistic regression analysis for influencing factors. 
Results In total, 21.1% (1 769/8 386) of people chose "Yes" to agree to the request of the patient′s guardian; there were significant differences in attitudes towards "withdrawal of effective treatment" among medical staff of different genders, ages, marital status, the highest education level, job categories, professional titles, departments, and hospital types (P<0.05). In addition, 66.5% of medical staff adopted different measures based on clinical practice. The results of binary logistic regression analysis showed that males, postgraduate degree, medical staff, emergency department and non-private hospitals were risk factors for the choice of medical staff to"withdraw effective treatment". Medical staff aged 44 and above, with higher job satisfaction and patient trust, were less likely to agree to the patient′s family′s request to "withdraw effective treatment" (P<0.05). 
Conclusion In-depth research on policies, regulations and ethics related to withdrawal of treatment should be carried out, to provide guidance for medical decisions on life and death of end-stage patients. Standard procedures for withdrawal of treatment should be established to explore feasible models for shared decision making. 


Key words: withdrawing treatment, medical staff, doctor-patient decision