终生决策措施的识别和综合:一个范围审查
Patricia Bucko1, Miriam A Novack1, Emily H Ho1
1Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Frontiers in medicine
|August 18, 2025
概括
这次审查发现很少有措施来评估认知障碍的老年人生命终端决策. 需要更多的研究来为这些弱势群体开发可靠的工具.
科学领域:
- 老年学是指老年学的学科.
- 认知科学 认知科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 认知障碍 (CI) 在老年人中显著影响决策 (DM).
- 终身护理 (EoL) 涉及到由患者价值观和偏好影响的复杂决策.
- 需要标准化措施来评估EOL决策和准备,但它们的可用性在很大程度上是未知的.
研究的目的:
- 进行对有关EOL决策措施的现有文献进行范围审查.
- 确定和描述用于评估老年人DM的措施,特别是在EOL环境中.
- 支持提升认知衰老和决策能力的可靠测量 (ARMCADA) 倡议.
主要方法:
- 根据阿克西和奥马利框架进行范围审查.
- 搜索了2018年1月至2023年11月期间发表的研究.
- 提取了45岁及以上参与者的DM领域,人口特征和DM措施的数据.
主要成果:
- 从34篇文章中确定了28个独特的EOL决策措施.
- 麦克阿瑟治疗能力评估工具 (MacCAT-T),决策冲突量表 (DCS) 和决策遗憾量表 (DRS) 是最常见的.
- 研究通常包括患有CI/痴呆症 (12%),癌症 (24%) 和慢性疾病 (16%).
结论:
- 在评估老年人EOL决策能力的验证措施中存在重大差距.
- 目前的措施主要关注决策偏好,有效性和冲突.
- 为老年人开发强大的EOL决策评估工具至关重要.
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