支持老年人改变生命的治疗决策中的共同决策:一篇评论
Fahad Saeed1,2,3,4, Areeba Jawed5, Shena Gazaway6
1Department of Medicine, University of Rochester Medical Center, Rochester, New York.
JAMA internal medicine
|October 27, 2025
概括
晚期慢性病 (CKD) 的老年人需要在透析之外做出明智的选择. 共享决策确保护理与患者目标保持一致,优先考虑生活质量和知情同意.
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
- 公共卫生 公共卫生
背景情况:
- 老年人是美国增长最快的开始透析的人口.
- 透析往往是默认的,尽管移植资格不合格和错误的患者目标优先考虑生活质量.
- 许多老年患者没有充分了解所有治疗选择.
研究的目的:
- 引导初级保健临床医生与老年人,家庭和科专家合作.
- 促进高级慢性病 (CKD) 治疗的共享决策.
- 确保以患者为中心,符合目标的CKD管理.
主要方法:
- 这是一个叙事评论.
- 它综合了当前对老年人治疗选择的理解.
- 它的重点是共享决策的过程.
主要成果:
- 治疗的选择包括移植,透析和保守的管理.
- 共享决策包括基于证据,患者目标和风险效益分析的联合规划.
- 时间有限的透析试验等方法可以解决决策不确定性.
结论:
- 对于患有晚期CKD的老年人来说,共享决策至关重要,以了解选择,并做出符合目标的选择.
- 初级保健和科之间的合作对于协调,以患者为中心的护理至关重要.
- 这种方法支持明智的决策,与患者的优先事项保持一致,例如生活质量.
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