Medical staff's decision-making process in the nursing home.
Medical staff's decision-making process in the nursing home.
复制标题
疗养院医务人员的决策过程。
DOI：
10.1093/gerona/58.3.m271
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Lipson,Steven
中科院分区：
文献类型：
--
作者：
Cohen-Mansfield,Jiska;Lipson,Steven
背景：本文描述了在养老院发生状态改变事件时的医疗决策过程。方法：6名男性医生和3名女性护士完成了一份问卷，描述了一家大型非营利性养老院70名居民的医疗决策过程。结果：住院是最常被考虑和选择的治疗方法;家庭成员参与了39%的决策，护士参与了34%。据报告，在作出决定时最重要的考虑因素是居民的生活质量、治疗方案的相对有效性和家庭的愿望。考虑因素的重要性水平与医生的身份，具体的居民特征，（如预期寿命），以及医生和居民之间的沟通（如分享家庭愿望的知识）。结论。在状态改变事件发生时的决定涉及多种条件、多种考虑和多种治疗方案，并且倾向于导致诸如住院的主动途径或诸如舒适护理的被动途径。医师个人及医师与住院医师的关系对这一过程的影响值得进一步研究。
Background.This paper describes the medical decision-making process at the time of status change events in the nursing home.Methods.Six male physicians and 3 female nurse practitioners completed questionnaires that described the medical decision-making process for 70 residents of a large nonprofit nursing home.Results.Hospitalization was the most frequently cited treatment considered and chosen; family members were involved in 39% of decisions, and nurses were involved in 34%. The most important considerations in making a decision were reported to be the resident's quality of life, the relative effectiveness of the treatment options, and the family's wishes. The levels of importance ascribed to the considerations were related to the physician's identity, specific resident characteristics (such as estimated life expectancy), and communication between the physician and resident (such as sharing knowledge of family wishes).Conclusions.The decision at the time of a status change event involves multiple conditions, multiple considerations, and multiple treatment options, and tends to result in either an active route, such as hospitalization, or a passive one, such as comfort care. The impact of the individual physician and the physician–resident relationship on this process deserves further investigation.