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COPD. A Model for Using Advance Directives and Care Planning
Authors:Azucena Couceiro Vidal  Andrés Pandiella
Affiliation:1. Unidad de Gestión Clínica de Rute, Rute, Córdoba, España;2. Unidad Docente de Jaén, Jaén, España;3. Unidad de Gestión Clínica de Fuente Palmera, Fuente Palmera, Córdoba, España;4. Universidad de Granada, Granada, España;5. Unidad de Gestión Clínica Conil-La Janda, Conil-La Janda, Cádiz, España;1. School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan;2. Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan;3. Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan;4. Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan;5. Department of Medicine, Chang Gung University, Tao-Yuan, Taiwan;1. Centro de Atención Primaria Terrassa Sud, Unidad Docente de Medicina Familiar y Comunitaria, Hospital Mútua de Terrasa (HMT), Terrassa, España;2. Unidad de Investigación, Fundación para la Investigación, Mutua de Terrassa, Barcelona, Universidad de Barcelona, Barcelona, España;1. Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain;2. CIBER de Enfermedades Respiratorias (CIBERES), Spain;3. 2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland;4. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;5. Department of Respiratory Medicine, Royal College of Surgeons, Dublin, Ireland;6. Optimum Patient Care, Cambridge, UK;7. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore;8. Duke-National University of Singapore Medical School, Singapore;9. Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark;10. Respiratory Department, Hospital de Alta Resolución de Loja, Spain;11. Department of Respiratory Medicine, Mater Dei Hospital, Malta;12. Public Health, Mental, Maternal and Child Health Nursing Department, Faculty of Medicine and Health Sciences, University of Barcelona, Spain;13. Department of Respiratory Medicine, Hospital Comarcal de Laredo, Cantabria, Spain;14. Respiratory and Critical Care Medicine, Changi General Hospital, Singapore;15. Primary Health-care Center Son Pisà, IB-Salut, Palma, Baleares, Spain;p. Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain;q. Centre of Academic Primary Care, University of Aberdeen, UK;r. Observational and Pragmatic Research Institute, Singapore;11. Hospital Universitari Vall d’Hebron, Barcelona, Spain;12. Hospital de Alta Resolución de Loja, Spain;13. Hospital Comarcal de Laredo, Cantabria, Spain;14. Primary Health-care Center Son Pisà, IB-Salut, Palma de Mallorca, Spain;15. Institute of Tuberculosis and Lung Diseases, Warsaw, Poland;16. St Mary''s Hospital, Seoul, Korea;17. Singapore General Hospital, Singapore;18. Changi General Hospital, Singapore;19. Optimum Patient Care, Cambridge, UK;110. Mater Dei Hospital, Malta;111. Royal College of Surgeons, Dublin, Ireland;1. National Taipei University of Nursing and Health Sciences, School of Nursing, Taipei, Taiwan;2. Taipei Veterans General Hospital, Department of Nursing, Taipei, Taiwan;3. National Taiwan University, College of Medicine, School of Nursing, Taipei, Taiwan;4. National Taiwan University Hospital, Department of Nursing, Taipei, Taiwan;5. National Taiwan University, College of Medicine, Taipei, Taiwan;6. National Taiwan University Hospital, Department of Family Medicine, Taipei, Taiwan;7. National Taipei University of Nursing and Health Sciences, Department of Speech Language Pathology and Audiology, Taipei, Taiwan
Abstract:Decision-making in COPD is complicated by the lack of clear prognostic factors. In this clinical situation it is also necessary to include the desires, values and choices of patients. The problem is more complex in the critical episodes, where the patients are incapable to make decisions. The instruments that allow incapable patients to represent themselves, the kind of patients who could benefit from its use, and the Spanish legislation on the matter, are presented in the first part of the work. The paper goes on to explain how to apply advance directives to the case of COPD. The article concludes that the appropriate use of advance directives and advanced care planning increases the quality of decisions at the end of the life of the patients with COPD.”
Keywords:Chronic obstructive pulmonary disease  Advance directives  Rejection of treatment  Quality of life related to health  Advance care planning  Bioethic  Enfermedad pulmonar obstructiva crónica  Directivas previas  Rechazo de tratamiento  Calidad de vida relacionada con la salud  Planificación anticipada de decisiones  Bioética
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