文章基本信息

标题：Do you agree with the doctor's decision to continue treatment. A scenario-based study of hospital nurses in Italy
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作者：Francesca Ingravallo ; Sara Sandroni ; Laura D'Addio 等
期刊名称：Annali dell'Istituto Superiore di Sanita
印刷版ISSN：0021-2571
出版年度：2015
卷号：51
期号：4
页码：352-357
DOI：10.4415/ANN_15_04_17
出版社：Editrice Kurtis Srl
摘要：Introduction. A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue. Materials and methods. Questionnaire including two clinical scenarios regarding doc- tor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487) of an Italian medium-sized hospital. Results. Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life. Discussion and conclusions. Many nurses have difficulty in accepting a patient's re- quest to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.
关键词：treatment refusal; patient autonomy; attitudes; end-of-life decisions; ethics