检查对寿命有限的老年人进行医疗干预的机会和挑战
Nancy L Schoenborn1, Anna S Beeber2, Vadim A Dukhanin3
1Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Sage open aging
|October 28, 2025
概括
在预期寿命有限的老年人中停止实施医疗干预措施,需要仔细考虑患者的偏好. 从基于年龄的决定转向基于预期寿命的决定对于适当的护理至关重要.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 医学伦理 医学伦理
背景情况:
- 医疗干预的好处和危害随着患者的年龄而变化,需要重新评估适当性和患者的调整.
- 预期寿命有限的老年人经常继续进行伤害超过益处的干预,突出了对撤销实施策略的需求.
- 患者的偏好和共享决策是优化老龄化人口医疗保健的关键考虑因素.
研究的目的:
- 审查对寿命有限的老年人进行医疗干预的机会和挑战.
- 探讨患者偏好和共享决策在这个退出实施过程中的关键作用.
- 识别脱离实施,共享决策和老龄化的交叉点上的研究差距.
主要方法:
- 关于老年人脱离实施的文献的批判性审查.
- 分析包括癌症查,多药和终身护理在内的例子.
- 检查与行为改变和决策框架相关的挑战.
主要成果:
- 取消实施是复杂的,涉及从基于年龄的决策转向基于预期寿命的决策.
- 现有的退出实施框架缺乏患者偏好的整合,而共享决策框架没有解决退出实施的具体问题.
- 诸如癌症查,多药房和终身护理等例子说明了这一人口群体的执行挑战.
结论:
- 关于退出实施,共享决策和老龄化,存在重大研究缺口.
- 取消实施的决定应评估偏好的敏感性,证据的强度,危害益处平衡和不可逆转性.
- 将患者偏好纳入退出实施框架对于老年人以患者为中心的护理至关重要.
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