İleri yaşın tıbbi ön direktif ve ilişkili kavramlara dair düşünce ve tutumlarını etkileyen faktörlerin değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Giriş ve Amaç: Her bireyin kendi geleceğini belirleme hakkı vardır ve bu hakkın sağlığa yansıması yapılan tıbbi müdahale ve tedavilere bireyin onam vermesidir. Hasta hakları çerçevesinde gerek karar verme yetimiz mevcutken gerek bu yetimizi yitirdiğimizde bize uygulanmasını istediğimiz tedavileri seçme ve reddetme hakkımız vardır. Ancak dünyada birçok kişi her yıl kendi isteklerine uymayan bir bakımı görürken ölmektedir. Bu araştırmada amacımız; Ege 3. Yaş Üniversitesi öğrencilerinin tıbbi ön direktif ve ilişkili kavramlar olan ileri bakım planları, gelecekteki bakımın planlanması, sağlık vekili, yaşam vasiyeti ve yaşam sonu tedavi tercihlerine ilişkin düşüncelerinin ve ilişkili etmenlerin belirlenmesidir. Gereç ve Yöntem: Çalışma iki aşamalı olarak tasarlanmış olup, ilk aşaması kesitsel tiptedir. Bu aşamada 175 Ege 3. Yaş Üniversitesi öğrencisiyle yüz yüze, anket formu kullanılarak veriler elde edilmiştir. Veriler SPSS 22.00 for Windows Programı kullanılarak analiz edilmiştir. Tanımlayıcı analizlerde sayı ve yüzdeler hesaplanmıştır. Çözümleyici analizlerde ki-kare analizi, ileri analizler için lojistik regresyon analizi ve korelasyon analizi uygulanmıştır. p<0,05 istatistiksel anlamlılık düzeyi olarak belirlenmiştir. İkinci aşamada ise kesitsel çalışmaya olumlu ve olumsuz yanıt veren 5'er kişi ile derinlemesine görüşme yapılmıştır. Görüşmeler tıbbi ön direktif, sağlık vekili ve yaşam sonu tedaviler olmak üzere üç tema üzerine yapılandırılmıştır. Bulgular: 60-88 yaş arası 175 kişiden oluşan grubun ortalama yaşı 69,0 olup, grubun %77,1'i kadın, %22,9'u erkektir. %49,7'si evli olup, %44,6'sı yalnız yaşamaktadır. Katılımcıların %62,3'ü lisans, %30,3'ü lise ve %7,4'ü ilk-orta okul mezunudur. Katılımcılar "TÖD vermek ister miydiniz?" şeklindeki soruya %53,1 "evet", %33,1 "kararsızım" ve %13,7 "hayır" yanıtını vermiştir. Katılımcıların %70,3'ü bir sağlık vekili belirlemek istemektedir. Sağlık vekili olarak çocukların tercih edilmesi oranı %52,1, eşin tercih edilme oranı ise %33,6'dır. Katılımcıların %87,4'ü "ağrı ve acının dindirilmesini isterim" sorusuna "evet" derken, bu oran "yaşam destek ünitesine bağlanmak isterim" sorusunda %49.1 olmuştur. "Antibiyotik tedavisi, kan transfüzyonu, diyaliz gibi tedavilerin uygulanmasını isterim" sorusuna katılımcıların %59,4'ü "evet" derken, "yaşam sonu döneminde kalp ve solunum durması halinde yeniden canlandırma yapılmasını isterim" şeklindeki soruya katılımcıların % 57.1 'i evet yanıtını vermiştir. Sonuç: 1998 yılında yayımlanmış olan Hasta Hakları Yönetmeliği ile bireye tedaviyi seçme ve reddetme hakkı verilmiş olsa da halihazırda ülkemizde tıbbi ön direktiflerin uygulanmasına yönelik bir düzenleme mevcut değildir. Çalışmanın sonuçlarına göre ülkemizde uygulanıyor olması halinde TÖD ve ileri bakım planları hazırlama ve kendi karar veremediği döneme ilişkin adına karar verecek bir sağlık vekili belirleme isteği yüksektir. Toplum, politika yapıcılar, hukukçular ve sağlık çalışanları arasında TÖD ve ilişkili kavramlar konusundaki tartışmalar teşvik edilmelidir. Anahtar Kelimeler; Tıbbi Ön Direktif, İleri Bakım Planları, Sağlık Vekili, Yaşam Sonu Bakımı
Introduction and Aim: Every individual has the right to determine one's future and this right's reflection on health is getting informed consent for medical interventions and treatments. Within the framework of patient rights, one has the right to choose and reject treatments that one wants to be administered, both when the ability of decision making is present and when this ability is lost. However, many people die as they are getting the treatment that is not following their demands every year. This research aims to determine both the thoughts and related factors of Ege 3rd Age University students, who keep learning throughout their lives, about advance directive and related concepts such as advance care planning, planning of future care, health care surrogate, living wills and preferences upon end-of-life treatments. Methods: The study is designed as two-staged, and the first stage is cross-sectional. In this stage, data is collected from 175 students from Ege University of the Third Age by conducting surveys face to face. Datas are analyzed with SPSS 22.00 for Windows Program. Numbers and percentages are calculated in descriptive analysis. Chi-Square test and as advance analysis logistic regression analysis and correlation analysis are used in analytical analysis. The statistical significance value is determined as P<0.05. In the second stage, meetings are conducted throughout with five people responding positively and five people responding negatively to the cross-sectional study. Meetings are constructed upon three themes following advance directive, health care surrogate and end of life treatments. Results: Mean age of the group consisting of 175 people aged between 60 and 88 is 69,01. 77,1% of the group is female and 22,9% is male. 49,7% are married and 44,6% are living alone. 62,3% of participants have bachelor's degrees, 30,3% are high-school graduates and 7,4% are elementary-secondary school graduates. 53,1% of participants answered "yes", 33,1% answered "indecisive" and 13,7% answered "no" to "Do you want to give advance directive?". 70,3% of participants want to designate a health care surrogate. The ratio of designated health care surrogate being their children is 52,1% and the ratio of preferring health care surrogates as their spouse is 33,6%. 87,4% of participants answered the question of "I want the ache and pain to be relieved" as "yes", 49,1% answered "yes" to the question of "I want to be in a life support unit". 59,4% of participants said "yes" to "I want treatments such as antibiotics, blood transfusions, dialysis to be conducted" and 57,1% of participants gave the answer "yes" to "I want revitalization to be done in case of cardiac and respiratory arrest in the end-of-life period". Discussion: Even though the Regulations of Patient Rights, published in 1998, conferred rights to individuals to choose and reject treatment, there is no regulation about the implementation of advance directives present in our country right now. According to the results of the study, in case of implementation in our country demands of advance directive and advance care planning and designation of a health care surrogate who will make decisions when the patient cannot decide for one's self is high. Society, politicians, legists, and health care workers must be encouraged to discuss about advance directive and concepts related to it. Keywords: Advance Directive, Advance Care Planning, Health Care Surrogate, End of Life Care.
Introduction and Aim: Every individual has the right to determine one's future and this right's reflection on health is getting informed consent for medical interventions and treatments. Within the framework of patient rights, one has the right to choose and reject treatments that one wants to be administered, both when the ability of decision making is present and when this ability is lost. However, many people die as they are getting the treatment that is not following their demands every year. This research aims to determine both the thoughts and related factors of Ege 3rd Age University students, who keep learning throughout their lives, about advance directive and related concepts such as advance care planning, planning of future care, health care surrogate, living wills and preferences upon end-of-life treatments. Methods: The study is designed as two-staged, and the first stage is cross-sectional. In this stage, data is collected from 175 students from Ege University of the Third Age by conducting surveys face to face. Datas are analyzed with SPSS 22.00 for Windows Program. Numbers and percentages are calculated in descriptive analysis. Chi-Square test and as advance analysis logistic regression analysis and correlation analysis are used in analytical analysis. The statistical significance value is determined as P<0.05. In the second stage, meetings are conducted throughout with five people responding positively and five people responding negatively to the cross-sectional study. Meetings are constructed upon three themes following advance directive, health care surrogate and end of life treatments. Results: Mean age of the group consisting of 175 people aged between 60 and 88 is 69,01. 77,1% of the group is female and 22,9% is male. 49,7% are married and 44,6% are living alone. 62,3% of participants have bachelor's degrees, 30,3% are high-school graduates and 7,4% are elementary-secondary school graduates. 53,1% of participants answered "yes", 33,1% answered "indecisive" and 13,7% answered "no" to "Do you want to give advance directive?". 70,3% of participants want to designate a health care surrogate. The ratio of designated health care surrogate being their children is 52,1% and the ratio of preferring health care surrogates as their spouse is 33,6%. 87,4% of participants answered the question of "I want the ache and pain to be relieved" as "yes", 49,1% answered "yes" to the question of "I want to be in a life support unit". 59,4% of participants said "yes" to "I want treatments such as antibiotics, blood transfusions, dialysis to be conducted" and 57,1% of participants gave the answer "yes" to "I want revitalization to be done in case of cardiac and respiratory arrest in the end-of-life period". Discussion: Even though the Regulations of Patient Rights, published in 1998, conferred rights to individuals to choose and reject treatment, there is no regulation about the implementation of advance directives present in our country right now. According to the results of the study, in case of implementation in our country demands of advance directive and advance care planning and designation of a health care surrogate who will make decisions when the patient cannot decide for one's self is high. Society, politicians, legists, and health care workers must be encouraged to discuss about advance directive and concepts related to it. Keywords: Advance Directive, Advance Care Planning, Health Care Surrogate, End of Life Care.
Açıklama
02.02.2023 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır
Anahtar Kelimeler
Geriatri, Geriatrics, Hukuk, Law, İç Hastalıkları, Internal diseases
