Medical Decision-Making Capacity and Cataract Surgery
Medical Decision-Making Capacity and Cataract Surgery
复制标题
DOI：
10.1097/opx.0b013e31826a3d85
复制
发表时间：
2012-10-01
影响因子：
1.4
通讯作者：
Swanson, Mark W.
中科院分区：
文献类型：
--
作者：
Swanson, Mark W.
背景资料。医疗决策已经从一种家长式的“医生至上制”演变为医疗服务提供者和患者共同决策的模式。共同决策涉及患者对所提议的医疗方案和医疗决策能力的知情同意。90岁及以上的成年人是美国人口中增长最快的部分。痴呆症在这一群体中的患病率急剧上升。痴呆症可能会影响患者参与共同决策的能力。本文报告一位91岁女性康复科住院病人，患有轻度认知障碍、白内障及黄斑变性。该案例突出了与白内障手术相关的知情决策和医疗决策能力的关键问题。提供了评估认知和医疗决策能力的视频示例。(Optom Vis Sci 2012；89：E23-E26)
Background. Medical decision making has evolved from a paternalistic, "doctor knows best system" to one of shared decision making between health care providers and patients. Shared decision making involves informed consent related to the proposed health care options and medical decision-making capacity by patients. Adults aged 90 and older are the fastest growing segment of the US population. Dementia prevalence increases dramatically among this group. Dementia may affect the ability of patients to participate in shared decision making.Case Report. The case of a 91-year-old female rehabilitation inpatient with mild cognitive impairment, cataracts, and macular degeneration is presented. The case highlights key issues of informed decision making and medical decision-making capacity related to cataract surgery. Video examples of the assessment of cognitive and medical decision-making capacity are presented. (Optom Vis Sci 2012; 89:e23-e26)