97名癌症住院患者的决策能力评估:呼吁进行标准化
Daniel McFarland1, Yesne Alici2, Natalie T Kostelecky3
1Department of Psychiatry, University of Rochester, Rochester, NY; Department of Medicine, Division Hematology and Medical Oncology, Wilmont Cancer Center, University of Rochester, Rochester, NY.
概括
许多住院的癌症患者缺乏决策能力 (DMC),影响护理. 这项研究强调了精神病学顾问对DMC的不一致评估,敦促进行标准化的文档和评估流程,以改善患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 精神病学是一个精神病学.
- 医学伦理 医学伦理
背景情况:
- 住院的癌症患者经常面临影响他们的护理和生活质量的关键决策.
- 一个重大挑战是这些患者普遍缺乏决策能力 (DMC).
- 值得注意的是,在住院瘤组和咨询联络精神病学家对DMC评估缺乏标准化的协议.
研究的目的:
- 描述精神病学咨询的经验,以评估在一个机构住院的癌症患者的决策能力 (DMC).
- 根据咨询的原因和患者能力状况,识别DMC评估的变化.
- 评估DMC评估中的咨询-联络精神病学的文档实践.
主要方法:
- 在2017年至2019年期间,对DMC评估的97次连续精神病学咨询进行了回顾性图表审查.
- 收集的数据包括人口统计,医院和精神病咨询细节.
- 分析的重点是与DMC评估的原因和患者容量以及文档质量相关的差异.
主要成果:
- 在接受评估的住院癌症患者中,59%的人无法证明有决策能力.
- 对DMC的精神病咨询几乎完全源自医疗服务.
- 咨询联络精神科医生对DMC评估的文档往往不完整,缺乏关键决定因素,可逆性或替代信息.
结论:
- 对于住院癌症患者的DMC评估的文档存在显著的异质性.
- 决策能力评估的文档需要更加严格和标准化.
- 改进标准化可能会提高弱势癌症患者的护理质量和决策支持.
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