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Updated: Mar 7, 2026

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Oral Health Assessment by Lay Personnel for Older Adults
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使用RAND/UCLA适当性方法定义老年人手术共享决策:一个共识声明
Gabriela Poles1, Alexis Zimmer2, Janet Tran3
1Department of Surgery, University of Rochester, Rochester, New York.
JAMA network open
|March 6, 2026
概括
这项研究确定了43个有效和可行的组件,用于在接受手术的老年人中共享决策 (SDM). 这些组件旨在改善手术前的沟通,并指导未来的干预,以改善手术护理.
科学领域:
- 老年医学 老年医学
- 手术护理 手术护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年人面临重大手术后的重大风险,包括功能衰退和认知障碍.
- 共享决策 (SDM) 对这一群体至关重要,但缺乏标准化的指导方针.
- 缺乏定义的SDM组件阻碍了老年手术患者的有效沟通和护理规划.
研究的目的:
- 确定针对老年人专门定制的手术共享决策 (SDM) 的有效和可行的组件.
- 在老年外科护理中建立SDM的标准化框架.
- 通知开发干预措施,以改善老年患者的SDM.
主要方法:
- 使用RAND/UCLA适当性方法,采用了两轮修改后的Delphi过程.
- 41个候选SDM组件由11名小组成员 (临床医生和患者代表) 开发和评价.
- 在有效性和可行性方面达成共识,使用7.0或更高的中位数得分与统计协议.
主要成果:
- 总共有43个有效和可行的组件被确定为老年人手术SDM.
- 实施障碍包括知识/技能缺口 (33.5%),时间限制 (26.2%) 和文化因素 (18.3%).
- 具体的挑战包括评估认知功能和就长期结果提供咨询.
结论:
- 确定了43个组成部分,为增强老年手术术前沟通和质量测量提供了一个框架.
- 解决实施障碍对于成功整合这些SDM组件至关重要.
- 该框架支持开发干预措施,以改善老年手术患者的SDM.
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