广西医学

目的探讨癌症晚期患者代理决策者安宁疗护决策后悔现状，并分析其影响因素。方法采用便利抽样法，选取306名癌症晚期患者安宁疗护代理决策者作为研究对象，采用一般资料调查问卷、中文版决策后悔量表（DRS）、中文版照顾者准备度量表（CPS）、决策冲突量表（DCS）、濒死及死亡质量问卷（QODD）对其进行问卷调查，采用多重线性回归模型分析癌症晚期患者安宁疗护代理决策者安宁疗护决策后悔的影响因素。结果癌症晚期患者代理决策者的DRS总分为（37.07±14.03）分，有85.95%癌症晚期患者代理决策者存在高水平安宁疗护决策后悔。不同性别、与患者关系、与医生的信任关系、对安宁疗护了解程度及是否选择造成患者痛苦而效果有限的治疗方案的癌症晚期患者安宁疗护代理决策者的DRS总分比较，差异有统计学意义（P<0.05）。癌症晚期患者代理决策者的DRS总分与CPS总分、QODD总分呈负相关，与DCS总分呈正相关（P<0.05）。与医生的信任关系、对安宁疗护了解程度、是否选择造成患者痛苦而效果有限的治疗方案、死亡准备度、决策冲突、患者濒死及死亡质量是癌症晚期患者代理决策者安宁疗护决策后悔的影响因素（P<0.05）。结论癌症晚期患者代理决策者存在较高水平的安宁疗护决策后悔，且受与医生的信任关系、对安宁疗护了解程度、是否选择造成患者痛苦而效果有限的治疗方案、死亡准备度、决策冲突、患者濒死及死亡质量等因素的影响。

Objective To investigate the current status of regret regarding palliative care decisions among surrogate decision⁃makers of patients with advanced cancer, and to analyze its influencing factors. Methods A total of 306 surrogate decision⁃makers for palliative care of patients with advanced cancer were selected as the research subjects using a convenience sampling method. They were surveyed using a general information questionnaire, the Chinese version of the Decision Regret Scale (DRS), the Chinese version of the Caregiver Preparedness Scale (CPS), the Decisional Conflict Scale (DCS), and the Quality of Dying and Death Questionnaire (QODD). Multiple linear regression model analysis was used to identify factors influencing regret regarding palliative care decisions among surrogate decision⁃makers of patients with advanced cancer. Results The DRS total score for surrogate decision⁃makers of patients with advanced cancer was 37.07±14.03, among them, 85.95% reported high levels of regret regarding palliative care decisions. Statistically significant differences in DRS total scores were observed between surrogate decision⁃makers for palliative acre of patients with advanced cancer with different gender, relationship with the patient, trust in the physician, level of understanding of palliative care, and whether they opted for treatments causing patient suffering with limited efficacy (P<0.05). The DRS total score negatively correlated with the CPS total score and QODD total score, and positively correlated with the DCS total score in surrogate decision⁃makers of patients with advanced cancer (P<0.05). Factors influencing decision regret of palliative care in surrogate decision⁃makers of patients with advanced cancer included trust in the physician, level of understanding of palliative care, whether they opted for treatments causing patient suffering with limited efficacy, preparedness for death, decision conflict, and the quality of dying and death of the patient (P<0.05). Conclusion Surrogate decision⁃makers of patients with advanced cancer experience high levels of regret regarding palliative care decisions. This regret is influenced by factors such as trust in the physician, level of understanding of palliative care, whether opting for treatments causing patient suffering with limited efficacy, preparedness for death, decision conflict, and the quality of dying and death of the patient.