在与老年人进行治疗决策对话期间,与晚期病患者进行风险沟通
C B Shaw1, R Sowden1, F E M Murtagh2
1Palliative and End of Life Care Research Group, University of Bristol, UK.
Patient education and counseling
|August 16, 2025
概括
临床医生应讨论透析的风险和负担,以帮助老年病患者考虑保守性管理 (CKM) 作为有效的治疗选择. 这确保了晚期病患者的知情决策.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 医学沟通 医学沟通
背景情况:
- 大多数患有晚期病的老年人面临着有限的治疗选择:透析或保守管理 (CKM).
- 现有的研究表明,在临床环境中,人们倾向于讨论透析而不是CKM.
- 透析可能并不总是为老年患者或患有并发症的患者提供优越的益处.
研究的目的:
- 调查透析与CKM的风险和好处如何在咨询中传播.
- 确定沟通策略,将CKM定位为高级病老年人可行的治疗选择.
主要方法:
- 分析了英国部30次记录的门诊咨询,涉及65岁以上慢性病患者.
- 谈话的重点是透析和CKM之间的决定,涉及医生和护士.
- 利用对话分析来检查沟通模式.
主要成果:
- 当透析的风险,负担和有限的益处被清楚地传达时,患者认为保守的管理 (CKM) 是一个有效的选择.
- 有效的沟通包括讨论透析对生活质量的影响.
- 传达关于透析生存益处的不确定性和个性化风险信息至关重要.
结论:
- 临床医生的沟通策略可以显著影响患者对CKM作为有效的治疗选择的看法.
- 将透析风险和不确定性的框架赋予患者权力,在透析的同时考虑CKM.
- 这种方法支持对老年人晚期病管理的共享决策.
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