title: [Treatment choice for patients with hemorrhagic cerebral stroke expected to be in a disabled condition--An analysis of questionnaire responses of patients' families].
abstract: OBJECTIVE
  Many patients with cerebral stroke are successively treated with the latest advances in medical therapies. Surgical hematoma evacuation is a treatment option for patients with hemorrhagic cerebral stroke, however; it may result in a prolonged vegetative state. The difficult choice of whether or not such surgery should be performed is mostly made by the family, frequently in an urgent manner, and nurses need to understand the factors affecting this decision-making.
  
  
  METHODS
  We performed statistical analyses on the responses of 30 patients' families who answered our questionnaire, presuming disabilities after the surgery were expected. Multiple answers were obtained according to the severity of the expected disabilities after the surgery.
  
  
  RESULTS
  The refusal of surgery increased as the expected disabilities worsened, and the statistically significant factor affecting the decision-making process was "what they would wish if they suffered a stroke themselves." The 18 nurses working in the neurological ward who responded to the same questionnaire wished surgery more in the case of the patient's cognition being preserved.
  
  
  CONCLUSIONS
  Since it is rare for patients with stroke to have an advance directive, patients' families have to decide the treatment choice in most cases. In the clinical setting, such decisions frequently need to be made rapidly, however; the decision should be made by speculating on the patients' own will, and it is desirable for medical staff to explain the expected outcomes of the surgery in detail as far as possible.
authors.affiliation: Nursing Department, National Hospital Organization Okayama Medical Center.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Torigoe
authors.forename: Toru
authors.initials: T
authors.lastname: Fukuhara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications; D003657:Decision Making; D006233:Persons with Disabilities; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000628:therapy*; D011795:Surveys and Questionnaires