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病学家对老年人末期病临床治疗的观点和经验
Melissa W Wachterman1,2,3, Anupallavi Sinha3, Tarikwa Leveille3
1Section of General Internal Medicine, Veterans Affairs Boston Health Care System, Boston, Massachusetts, USA.
Journal of the American Geriatrics Society
|May 22, 2024
概括
科医生认为透析和临终关怀是不相容的,这阻碍了老年人患有末期脏疾病 (ESKD) 的及时临终关怀. 改善培训和政策变化对于更好的息护理整合至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 抚慰性护理是一种缓解性护理.
- 老年病的医生 老年病的医生
背景情况:
- 临终关怀改善了患者和家人的结果.
- 末期脏病 (ESKD) 的老年人中,临终关怀的利用率很低,大多数人入学迟到了.
- 对于患有ESKD的老年人,及时提供高质量的临终关怀的障碍需要探索.
研究的目的:
- 探讨对患有ESKD的老年人及时提供高质量的临终关怀的障碍.
- 了解病学家对晚期慢性病患者住院整合的观点.
主要方法:
- 使用采访成绩单的二次分析进行定性研究设计.
- 与20名美国科医生进行了半结构面试,以了解晚期CKD的治疗决策.
- 面试数据的新兴主题分析,以确定宿舍护理障碍.
主要成果:
- 科医生通常支持临终关怀,但很少看到患者接受它.
- 确定了关键障碍: (1) 相信透析和临终关怀是相互排斥的, (2) 对护理管理角色的不确定性.
- 这些障碍源于对临终关怀症状,政策问题以及科医生/临终关怀准备不足的狭看法.
结论:
- 科医生需要在初级息治疗,临终关怀和跨学科合作方面进行加强的培训.
- 建议对医疗保险政策进行调整,以促进住院接入.
- 了解科医生的观点对于改善ESKD患者生命末期护理至关重要.
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