传播痴呆症诊断的最佳实践:多利益相关者修改的德尔菲共识过程的结果
Melissa J Armstrong1, Noheli Bedenfield1, Monica Rosselli1
1Department of Neurology (MJA, NB, YM), University of Florida College of Medicine; UF Health Fixel Institute for Neurological Diseases (MJA, NB, YM), Gainesville; Department of Psychology (MR), Florida Atlantic University, Davie; Department of Psychiatry and Behavioral Sciences (RECC), University of Miami Miller School of Medicine; FL Neuro-Health (MK), Miami; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, Boca Raton; Department of Neurology (CL); Department of Psychiatry and Psychology (CL), Mayo Clinic, Jacksonville; Byrd Alzheimer's Institute (AGS); Department of Psychiatry and Behavioral Neurosciences (AGS), Morsani College of Medicine, University of South Florida, Tampa; Louis and Anne Green Memory and Wellness Center (MÁO), Christine E. Lynn College of Nursing, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton; Alzheimer's Association (JS, DM), Florida Region, Clearwater; Department of Health Outcomes and Biomedical Informatics (CLB), University of Florida College of Medicine, Gainesville, FL; and [N/A - caregiver representative] (DW).
确定了七种提供痴呆症诊断的最佳实践,强调了患者和护理人员的同情心,现实的希望和资源联系. 这些指导方针旨在改善对接受痴呆症诊断的人的沟通和支持.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 许多痴呆症患者及其家属没有得到正式诊断.
- 现有的痴呆症诊断标准已经有十多年了,缺乏患者/护理人员的意见.
研究的目的:
- 为了确定提供痴呆症诊断的最佳实践.
- 利用当前的文献和利益相关者的共识,更新诊断通信标准.
主要方法:
- 召集了一个多方利益相关者工作组 (患者,护理人员,临床医生).
- 使用了修改后的Delphi方法,在3轮的匿名投票中进行了投票.
- 纳入了美国神经病学会的推开发过程.
主要成果:
- 在7个关于痴呆症诊断沟通的最佳实践陈述上达成共识.
- 关键实践包括富有同情心的交付,评估患者的偏好,灌输希望,提供战略,资源和书面摘要.
- 陈述实现了A或B级别的证据.
结论:
- 建立了关于痴呆症诊断沟通的7点最佳实践框架.
- 强调需要进行定制讨论,医疗系统支持和临床医生培训.
- 强调文化敏感的方法和进一步的研究,以改善痴呆症护理沟通.
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