老年医療と緩和医療における目標一致の患者中心の測定: スコーピングレビュー
Isaac S Chua1,2,3, Annelise Berler4, Kacy Ninteau5
1Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA network open
|September 4, 2025
まとめ
この研究では,重症患者や高齢者のための目標一致の基準を特定し,説明しています. 老年医療と緩和医療における将来の測定開発を導くための概念モデルを提案しています.
科学分野:
- 高齢者医療
- 緩和ケア
- 医療サービス研究
背景:
- 重篤な病気や多発性症や老年症候群の高齢者の 高品質のケアには 目標の一致が不可欠です
- 目標コンコンダンスを測定するための標準化された方法は,現在欠けている.
- 患者と介護者の見解を正確に反映するために 既存の措置を評価する必要があります
研究 の 目的:
- 患者と介護者が報告した目標一致の指標を特定し,記述する.
- 重篤な病気と高齢者の集団における目標の一致を測定するための概念モデルを開発する.
- 高齢者医療と緩和医療における 強力な測定ツールの開発を促す.
主な方法:
- 電子データベース (MEDLINE,Embase,Web of Science,CINAHL,PsycINFO) の包括的なスコーピングレビューは2024年9月まで行われました.
- 含まれている研究は,様々なデザイン (RCT,観察,定性等) を含む. 目標コンコンダンス対策に重点を置く
- データの抽出と合成は2人の独立した審査員によって行われ,測定の特徴と枠組みのパターンが特定されました.
主要な成果:
- 63件の試験が対象対象対象の基準を満たし,67件の単一の目標一致度合いを示した.
- 大半の研究は重症患者に焦点を当てた.
- 患者の好み,受けた/意図した治療,好みとの調和,成果の達成といった4つの主要な要素からなる概念モデルが開発されました.
結論:
- このレビューは,脆弱な患者集団のための既存の目標コンコードンス対策の包括的な概要を提供します.
- 提案された概念モデルは,将来の測定ツールの開発と精錬のための枠組みを提供します.
- この発見は 老年医療と緩和医療における 人を中心としたケアを進める上で重要だ.
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