关键词: 生前预嘱；利益相关群体；签署过程；错位；现象学研究

Abstract: Objective: To analyze the dilemmas and challenges faced by various stakeholder groups in the process of signing living wills, and to provide reference for optimizing the signing strategy of living wills. Methods: This study adopted a phenomenological research method to conduct semi-structured interviews with a total of 33 people from Shenzhen city from July to November 2023, including (potential) signers of living wills, family members, healthcare professionals, social workers, and volunteers, and analyzed the data by using the Colaizzi 7-step analysis method. Results: Three themes and six sub-themes were identified: spatial mismatch (outside the hospital, inside the hospital), temporal mismatch (it is too early, it is too late), and subject mismatch (family members "overstepping the bounds", patients "giving way"). Conclusion: The mismatch of the three dimensions of place, time, and subject of decision-making in the practice of signing living wills has led to the cold reception of living wills in the promotion and implementation of living wills. It is suggested that in the future, it is necessary to build a communication platform for all stakeholder groups, strengthen life education, and establish the concept of living wills among the public, so as to promote the consensus related to the signing of living wills.

Key words: living will; stakeholders; signing process; mismatch; phenomenological study