预先计划:为社区居住的老年人增加死亡风险预先计划护理的随机试验协议
Alexia M Torke1,2,3, Susan Hickman2,4, Lucia Wocial5
1Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA atorke@iu.edu.
BMJ open
|May 24, 2025
概括
促进预先护理规划 (ACP) 改善了对老年人,包括痴呆症患者的护理与患者偏好保持一致. 这项研究评估了非洲,非洲和非洲国家和地区 (ACP) 的情况.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 生物伦理学生物伦理学
背景情况:
- 提前护理计划 (ACP) 对于将患者的医疗护理与他们的偏好保持一致至关重要.
- 需要高质量的证据来评估非洲和非洲国家干预措施的有效性.
- 老年人,包括患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的老年人,是ACP的关键人口.
研究的目的:
- 确定促进ACP对患者治疗偏好与接受治疗之间的不一致的影响.
- 评估非洲和非洲国家对决策质量,终身护理和相关成本的影响.
- 评估预先计划随机对照试验干预措施的有效性.
主要方法:
- 一个随机对照试验,涉及社区居住的高死亡风险的老年人.
- 干预使用了由注册护士提供的尊重选择先进步骤 (RCAS) 模型.
- 包括患者价值观的澄清,ACP教育和医生订单维持生命治疗 (POLST) 形式的填写.
主要成果:
- 主要结果是减少患者偏好与干预后一年接受的医疗治疗之间的不一致.
- 二次结果包括决策质量和终身护理的改善.
- 此外,还将分析非洲和非洲国家干预的成本效益.
结论:
- 方便ACP旨在加强以患者为中心的护理,并改善老年人的结果.
- 该研究提供了关于结构化ACP方法的有效性有价值的数据.
- 调查结果将为临床实践和政策提供有关为弱势群体预先计划护理的信息.
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