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晚期病的老年患者及其家属如何理解功能和衰竭? 一个定性研究研究
Charlotte M Snead1, Robert A Kimmitt2,3, Fergus J Caskey1,4
1Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 1UD, UK.
BMC nephrology
|November 4, 2025
概括
老年患者误解病,影响治疗选择. 改善沟通和避免数值值是关于替代疗法 (KRT) 的明智决策的关键.
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
- 质量健康研究 质量健康研究
背景情况:
- 慢性病 (CKD) 的老年患者面临替代疗法 (KRT) 的不确定的好处.
- 对于KRT的决策需要了解患者对CKD及其治疗的看法.
- 这项研究探讨了老年患者和家人如何理解功能和衰竭,从而影响治疗选择.
研究的目的:
- 探索老年患者和家庭成员对功能和衰竭的理解.
- 调查这些理解如何影响脏替代疗法 (KRT) 治疗决策.
- 确定能够改善老年CKD患者知情决策的沟通策略.
主要方法:
- 对15名患者 (≥80岁或≥65岁并发病) 和12名家庭成员进行了半结构化采访,这些患者来自英国三个脏单位.
- 患者估计的淋巴膜过率 (eGFR) <15毫升/分钟/1.73米2,并且没有先前的KRT.
- 在采访成绩单上使用了感应主题分析和恒定比较技术.
主要成果:
- 确定了三个主题:"关键的血液清洁器官"",没有证人的功能和失败"和"量化和预测功能".
- 患者认为功能至关重要,但却无形地经历了衰竭,对临床医生的依赖性增加.
- 数字和图形数据影响了理解,"门"在透析和死亡之间创造了一个错误的二分法.
结论:
- 临床沟通,特别是eGFR值,导致误解,影响KRT在老年多病症患者的知情决策.
- 需要改进咨询方法,以提高患者对CKD和治疗选择的了解.
- 修改术语和不强调数字指标可以支持个性化的治疗选择.
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