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一般医生对老年患者慢性病的评估和管理-一种混合方法研究
Michelle Guppy1, Esther Joy Bowles2, Paul Glasziou3
1Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Qld, 4226, Australia. michelle.guppy@une.edu.au.
BMC primary care
|August 20, 2024
概括
一般医生管理慢性病 (CKD) 的老年人,优先考虑全身和以患者为中心的护理,适应指导方针以满足个人需求和多病症. 这种方法不同于标准推.
科学领域:
- 老年病的医生 老年病的医生
- 腎臟病學 (nephrology) 是一種神經病學.
- 一般实践 一般实践
背景情况:
- 慢性病 (CKD) 在老年人中很常见,通常与生活方式疾病和多病症共同发生.
- 目前的CKD指南没有考虑到诊断和管理中的特定年龄因素.
- 一般医生 (GPs) 是管理CKD的关键,特别是在老年人群中.
研究的目的:
- 调查澳大利亚全科医生如何评估和管理患有慢性脏病的老年患者.
- 确定GP的实践是否与已建立的CKD指南建议保持一致.
- 探索对老年CKD患者的指导方针应用的任何变化背后的原因.
主要方法:
- 一项涉及澳大利亚全科医生的混合方法研究.
- 一项匿名在线调查分发给9500名全科医生,其中399人完成了调查.
- 对27名全科医生进行了深入的采访,以了解他们对年龄较大的患有功能下降的老年患者的诊断和管理战略.
主要成果:
- 48%的全科医生认为现有的CKD指南对诊断和管理有用.
- 采访的主要主题包括:与年龄相关的功能下降,全身护理,以患者为中心以及护理的连续性.
- 一般医生认识到突然与稳定的低功能之间的区别,以不同的方式管理它们,并专注于生活质量和共享决策.
结论:
- 在治疗老年患者的CKD时,全科医生采用以患者为中心和全人为中心的方法,考虑到多病症.
- 现有的CKD指南需要调整,以更好地应对老年人多病症的复杂性.
- 未来的CKD指导方针应纳入与年龄相关的功能衰退以及多病症对功能的影响.
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