ABSTRACT
Objective:To investigate the awareness and attitude towards living wills among community-dwelling elderly in Taiyuan.Methods:A total of 540 residents aged 60 years or older were selected from six communities of Taiyuan city for face-to-face questionnaire survey from November 2018 to March 2019. Chi-square test and logistic regression model were used to analyze the influencing factors for awareness and attitude towards living wills.Results:The awareness rate of living wills in responders was 44.1%(226/513); and the awareness was significantly associated with age (χ 2=11.09, P=0.001), education level (χ 2=7.95, P=0.005), and daily living abilities (χ 2=8.10, P=0.017) of the residents. After the knowledge popularization, 49.9%(256/513) of responders were willing to sign the living order documents. The multivariate logistics analysis showed that residents with age of 60-74 years ( OR=2.151, 95% CI:1.380-2.941), with bachelor degree or above ( OR=3.048, 95% CI:1.571-5.913), with severely impaired activities of daily living ( OR=2.849, 95% CI:1.223-6.638), with multimorbidity ( OR=1.654, 95% CI:1.138-2.404), and with knowledge of living will ( OR=1.596, 95% CI:1.098-2.322) were more likely to sign a living will document. Conclusion:The awareness and acceptance of living wills among the community-dwelling elderly in Taiyuan city is not so high, and it is necessary to further strengthen the promotion of living wills in the city.
ABSTRACT
Objective@#To analyze related factors for whether or not to make the living will by investigating the current status of recognition and acceptance of living will among elderly inpatients in Shanxi Province, in order to provide the evidence for promoting the living will in elderly hospitalized patients in Shanxi Province.@*Methods@#A questionnaire survey was conducted on elderly inpatients in Shanxi Province from January 2017 to December 2017, including general information(age, gender, ethnicity, religious belief, dwelling place, education and profession, children, spouse), awareness of living wills and willingness to sign documents of "My Five Wishes" . The chi-square test and Logistic regression analysis were used to analyze the related factors for elderly inpatients' willingness to sign living will documents@*Results@#The 411 elderly inpatients in Shanxi Province had a low level of cognition of living will(146 cases, 35.5%). In general socio-demographic characteristics, only education level and profession were related to the cognition of living will(χ2=12.093 and 11.906, P=0.001 and 0.008). Multivariate Logistic regression analysis showed that as compared with inpatients aged 60-69 years, inpatients aged 70-79 years(OR=0.592, 95%CI: 0.360~0.974, P=0.039)and 80-89 years(OR=0.408, 95%CI: 0.238~0.701, P=0.001)held a significantly negative attitude towards signing the living will documents.According to dwelling place, as compared with countryside, urban elderly inpatients were more willing to sign living will documents in advance(OR=2.293, 95%CI: 1.335~3.940, P=0.003). At the comparison of other occupations with medical workers, teachers(P=0.429), civil servants(P=0.068), only medical workers(OR=3.156, 95%CI: 1.419-7.020, P=0.005)were more willing to sign living will documents in advance.As comparing elderly inpatients with children, the childless elderly inpatients were more willing to sign living will documents in advance(OR=3.156, 95%CI: 1.287~7.740, P=0.012).@*Conclusions@#Elderly inpatients in Shanxi Province have a low level of cognition of living will and a poor acceptance of signing the document of "my five wishes" in advance.In order to benefit the public, we need to increase the promotion and popularization of signing documents of living will in our province.
ABSTRACT
Objective To analyze related factors for whether or not to make the living will by investigating the current status of recognition and acceptance of living will among elderly inpatients in Shanxi Province,in order to provide the evidence for promoting the living will in elderly hospitalized patients in Shanxi Province.Methods A questionnaire survey was conducted on elderly inpatients in Shanxi Province from January 2017 to December 2017,including general information (age,gender,ethnicity,religious belief,dwelling place,education and profession,children,spouse),awareness of living wills and willingness to sign documents of"My Five Wishes".The chi-square test and Logistic regression analysis were used to analyze the related factors for elderly inpatients' willingness to sign living will documents Results The 411 elderly inpatients in Shanxi Province had a low level of cognition of living will(146 cases,35.5 ％).In general socio-demographic characteristics,only education level and profession were related to the cognition of living will(x2 =12.093 and 11.906,P =0.001 and 0.008).Multivariate Logistic regression analysis showed that as compared with inpatients aged 60-69 years,inpatients aged 70-79 years (OR =0.592,95 ％ CI:0.360 ～ 0.974,P =0.039) and 80-89 years (OR =0.408,95％ CI:0.238 ～ 0.701,P =0.001) held a significantly negative attitude towards signing the living will documents.According to dwelling place,as compared with countryside,urban elderly inpatients were more willing to sign living will documents in advance(OR =2.293,95％CI:1.335～3.940,P =0.003).At the comparison of other occupations with medical workers,teachers (P=0.429),civil servants (P =0.068),only medical workers (OR =3.156,95 ％ CI:1.419-7.020,P=0.005)were more willing to sign living will documents in advance.As comparing elderly inpatients with children,the childless elderly inpatients were more willing to sign living will documents in advance(OR=3.156,95％CI:1.287～7.740,P=0.012).Conclusions Elderly inpatients in Shanxi Province have a low level of cognition of living will and a poor acceptance of signing the document of "my five wishes"in advance.In order to benefit the public,we need to increase the promotion and popularization of signing documents of living will in our province.
ABSTRACT
A perícia médica é requisito obrigatório para a concessão da maioria dos benefícios concedidos pelo Instituto Nacional do Seguro Social. Trata-se de atividade complexa, pois exige amplos conhecimentos de medicina e de legislação, e que tem por finalidade garantir a subsistência do trabalhador segurado quando incapacitado. Verificou-se que diversos são os elementos passíveis de modificação e que beneficiariam o atuar do perito. A adequação do ambiente físico, o esclarecimento da população acerca das particularidades da atividade pericial, o fim da obrigatoriedade da entrega da Comunicação de Resultado de Requerimento pelo médico, a melhora do sistema informatizado disponibilizado, a discussão acerca do número de atividades agendadas por dia que respeite a capacidade do perito, afastando-o da exaustão e, portanto, dos erros, bem como o respeito às normas balizadoras da atividade médica emanadas dos conselhos de medicina, permitiriam o labor com a isenção e a autonomia necessárias.
The medical examination is a mandatory requirement for the granting of most of the benefits granted by theNational Social Security Institute. It is a complex activity that requires extensive knowledge of medicine andlaw and aims to ensure the maintenance of the insured worker when incapacitated. It was found that several elements are modifiable and which would benefit the work of the expert. The adequacy of the physical environment, clarification of the population about the particularities of expert activity, the end of the obligation by the physician to deliver the Communication of Results, the improvement of thecomputerized system available, the discussion about the number of scheduled activities per day that respects the ability of the expert, away from the exhaust and thus the errors, as well as respect for the rules that guide the best medical practice issued by the medical council, would allow the work to the exemption and thenecessary autonomy.