在有或没有认知缺陷的老年人选择性外科手术程序的共享决策
K D Valentine1,2, Ha Vo1, Brittney Mancini1
1Massachusetts General Hospital, Boston, MA, USA.
概括
认知不足的老年人可以参与共享决策 (SDM) 并完成调查. SDM 过程尺度可靠地测量了这个人群中的 SDM.
科学领域:
- 老年医学 老年医学
- 手术决策 - 手术决策
- 认知障碍评估认知障碍评估
背景情况:
- 老年人经常经历认知障碍,这可能会影响他们参与共享决策 (SDM) 和调查完成.
- 在老年人中评估SDM需要验证的工具来解释不同的认知状态.
研究的目的:
- 检查认知不充分和没有认知不充分的老年人手术决策过程.
- 在这个人口群体中评估SDM进程规模的心理特征.
主要方法:
- 一组65岁以上的预定接受选择性手术的患者完成了基线调查,包括SDM过程量表和蒙特利尔认知评估测试 (MoCA盲).
- 后续调查评估了决定后悔,并在访问后三个月重新测试了SDM流程规模的可靠性.
- 认知不足被定义为一个MoCA盲分低于19的.
主要成果:
- 40%的老年手术患者表现出认知不足.
- 在SDM过程得分,SURE得分或认知缺陷患者和没有认知缺陷患者之间的决策遗憾中没有观察到显著差异.
- 在SDM流程尺度中,缺失数据率低,可靠性好 (ICC=0.7).
结论:
- 患者报告的SDM,决策冲突和决策后悔在有或没有认知缺陷的老年人之间是可比的.
- SDM过程尺度是评估老年手术患者SDM的有效,可靠和可接受的衡量标准,不管他们的认知状态如何.
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