【摘要】 预立医疗照护计划是保障患者医疗自主权、提高患者临终质量的重要举措，分享患者意愿以增强信任（sharing patient’s illness representation to increase trust,SPIRIT）干预是美国预立医疗照护计划干预研究最成功的项目之一。通过系统综述SPIRIT干预的发展概况及特点，重点探讨了SPIRIT干预的优势与不足。研究发现，SPIRIT干预能够实现长时间的临床实践在于其形成了完整的干预体系。基于此，提出以社会文化背景为基础构建预立医疗照护计划干预体系，以全面且广泛的评估视角评价预立医疗照护计划干预体系，以持续质量改进为目标应用预立医疗照护计划干预体系。更多还原

【Abstract】 Advance care planning(ACP) is a crucial measure to ensure patient autonomy and improve end-of-life care quality.The sharing patient’s illness representation to increase trust(SPIRIT) intervention is one of the most successful ACP intervention studies in the United States. By systematically reviewing the development and characteristics of the SPIRIT intervention, this study focuses on its strengths and weaknesses. Research findings indicate that the sustained clinical application of the SPIRIT intervention lies in its comprehensive intervention system. Based on this, new insights are proposed: building the ACP intervention system based on social and cultural contexts, evaluating it from a comprehensive and broad perspective, and applying it with continuous quality improvement as the goal.更多还原