Do young adults complete health care proxies before anesthesia?

Matthew C. Spence , Theresa Serra , Elissa Gross
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Abstract

Background

Health care proxy (HCP) completion rates by older adults are relatively low; however, not much is known about proxy completion rates by younger adults.

Objectives

This study aimed to identify HCP completion rates amongst 18–21 year old young adults without intellectual disabilities admitted to a pediatric hospital peri-anesthesia care unit (PACU) and determine whether there was an association with any demographic factors.

Methods

Retrospective chart review was performed to describe demographic variables, presence of HCP, and relationship to proxy. The relationship between demographic groups and HCP completion was analyzed by chi-square analysis for categorical variables and student t-test for continuous variables.

Results

Overall, 31.4 % (128/408) of patients completed an HCP, and younger patients were more likely to have done so. Analysis showed no statistically significant relationship between other demographic variables and HCP completion. A majority of patients identified a parent as their proxy.

Conclusion

Less than one third of young adult patients admitted to a children’s hospital perioperative care unit completed a health care proxy. Other than age, there was no statistically significant difference in demographic variables between those who completed and did not complete a health care proxy. Further research is needed to validate these findings in other clinical settings and drive targeted initiatives to increase advance care planning among young adult patients.

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年轻人在麻醉前完成医疗保健代理吗?
老年人的卫生保健代理(HCP)完成率相对较低;然而,我们对年轻人的代理完成率知之甚少。目的本研究旨在确定18-21岁无智力障碍的儿科医院麻醉周围护理单元(PACU)的年轻人HCP完成率,并确定是否与任何人口统计学因素相关。方法回顾性分析人口统计学变量、HCP的存在及其与代理的关系。分类变量采用卡方分析,连续变量采用学生t检验,统计人群与HCP完成度的关系。结果总体而言,31.4%(128/408)的患者完成了HCP,年轻患者更有可能完成HCP。分析显示其他人口统计学变量与HCP完成率无统计学意义。大多数病人认为父母是他们的代理人。结论:在儿童医院围手术期护理单元住院的年轻成人患者中,完成卫生保健代理的不到三分之一。除年龄外,完成和未完成卫生保健代理的人在人口统计学变量方面没有统计学上的显著差异。进一步的研究需要在其他临床环境中验证这些发现,并推动有针对性的举措,以增加年轻成人患者的提前护理计划。
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