"What you Say Matters": Review of Clinical Outcome of Advanced Medical Directives Between Cancer and Non-cancer Patients in a Chinese Culture Society.

Autor:	Chan KP; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR., Chung WK; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR., Hsu DY; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR., Kong SY; Department of Medicine and Geriatrics, Pok Oi Hospital, Tin Shui Wai Hospital, New Territories, Hong Kong SAR., Tin W; Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong SAR., Chan CH; Palliative Home Care Team, NTWC, Hong Kong SAR., Hwang E; Palliative Home Care Team, NTWC, Hong Kong SAR., Chan OM; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR., Chui R; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR., Cheng HWB; Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong SAR.
Jazyk:	angličtina
Zdroj:	The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2024 Jul 26, pp. 10499091241268304. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1177/10499091241268304
Abstrakt:	Introduction: Advance medical directives (AMD) are statements made by individuals indicating the life-sustaining treatment that they would refuse in the future when they lost their mental capacity for medical decisions. While the proposal for the AMD legislation is ongoing locally in Hong Kong SAR, there are limited reviews on the clinical outcomes associated with it. Objective: To provide a comprehensive review on clinical outcomes of signed AMD. Methodology: Retrospective, multi-center study, which includes AMD signed within five cluster hospitals. Records of signed AMD from 1 st JAN 2020 to 31 st DEC 2022 were retrieved from a central registry. Clinical information of each patient was obtained from the electronic patient record. Result: 456 patients with documented AMD were included in the study. 91.6% of AMD were signed by palliative care (PC) team. Majority (74.6%) of the patients were accompanied by family members or friends when AMD were signed. The concordance rate between the AMD and the medical care received was 89.5%. No patient revoked their AMD. Cancer and non-cancer patients showed similar rates of AMD concordance, frequency of Accident & Emergency Department (AED) visits or acute ward admissions, duration of hospital stays in the 30 days before death, and prevalence of receiving invasive or intensive treatments. Conclusion: Our study demonstrated that PC team currently plays a pivotal role in AMD completion, and AMD remains important in ensuring patients' care preferences are executed across different medical conditions. With the upcoming AMD legislation in Hong Kong SAR, adequate promotion and education should be launched. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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