解决重要问题:一项试点研究和混合方法评估四个临床环境中的患者优先护理
Carolina Fonseca Valencia1,2,3, Brent R Schell3,4, Christa Guerrier5
1Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Journal of the American Geriatrics Society
|March 12, 2025
概括
患者优先护理 (PPC) 是一种可行的年龄友好的方法,适用于多种慢性疾病的老年人. 它有效地使医疗保健与患者的目标在各种环境和模式,包括远程医疗.
科学领域:
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 患有多种慢性疾病的老年人面临复杂的健康挑战.
- 患者优先护理 (PPC) 是一个以年龄为友好的框架,重点关注患者的价值观,偏好和健康优先事项.
- PPC旨在使医疗保健提供与患者声明的健康结果目标保持一致.
研究的目的:
- 在不同的临床环境中评估患者优先护理 (PPC) 的可行性和实施.
- 评估PPC对多种慢性疾病的老年人护理协调的影响.
- 探索临床医生对PPC实施障碍和促进者的观点.
主要方法:
- 患者优先护理 (PPC) 在VA医院系统中的四个临床环境中实施.
- 该方法利用了包括远程医疗在内的多种模式,在试点阶段收集了描述性措施.
- 在评估阶段使用了临床过程测量和临床医生半结构面试.
主要成果:
- 通过电话,视频和面对面进行了109次PPC对话.
- 参与者年龄较大 (平均80岁),主要是白人和男性,多发病率高,认知障碍和多药性.
- 关键的护理结局包括澄清治疗偏好,药物调整和耐用医疗设备订单.
结论:
- 患者优先护理 (PPC) 是一种可行的年龄友好的方法,可用于各种临床环境和模式.
- 扩大"重要的事情"对话对于开发和扩大年龄友好护理至关重要.
- 这项研究强调了对复杂人群的治疗与以患者为中心的目标保持一致的重要性.
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