对决策工具的范围审查,以支持能力受损的成年人的替代决策者
Seema King1, Brooklynn Fernandes2, Timothy S Jayme3
1Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Journal of the American Geriatrics Society
|February 24, 2024
概括
老年人的替代决策者 (SDM) 需要得到更好的支持. 这次审查发现现有的工具不能完全满足护理人员的需求,建议采用组合工具包方法.
科学领域:
- 老年学是一门学科.
- 医疗保健决策 - - 医疗保健决策
- 护理人员支持护理人员支持
背景情况:
- 替代决策者 (SDM) 对缺乏决策能力的老年人至关重要,特别是那些患有痴呆症的人.
- SDM经常因缺乏支持,信息和解决问题的工具而面临挑战,导致负面影响.
- 之前的研究突出了对SDM有必要的适应性支持系统的需求.
研究的目的:
- 为老年人的SDM确定基于证据的决策资源和工具.
- 概述SDM所需的支持领域.
- 评估已识别的资源和工具的有效性和有效性.
主要方法:
- 使用跨多个数据库的综合搜索策略进行了范围审查.
- 审查的重点是针对已失去决策能力的成年人的SDM.
- 研究小组评估了工具,包括患者合作伙伴,与之前识别的需求领域进行了对比.
主要成果:
- 该审查选了5279个引用,其中包括25篇文章用于数据提取.
- 确定了17种不同的决策工具,适合痴呆症轨迹的不同阶段.
- 没有一个单一的工具可以解决护理人员所识别的所有决策需求.
结论:
- 目前SDM的决策工具可能无法充分满足全方位的护理人员需求.
- 一个潜在的解决方案是通过结合现有资源创建一个工具包.
- 建议将工具应用量身定制为护理人员的具体旅程,以弥合支持差距.
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