Goals for the care of frail older adults: Do caregivers and clinicians agree?
Goals for the care of frail older adults: Do caregivers and clinicians agree?
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DOI：
10.1016/s0002-9343(00)00668-9
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发表时间：
2001-02-01
影响因子：
5.9
通讯作者：
Inouye, SK
中科院分区：
文献类型：
--
作者：
Bogardus, ST;Bradley, EH;Inouye, SK
目的：为患者建立共同的治疗目标可能会通过促进实现适当和期望的结果来提高护理质量。本研究的目的是描述认知障碍发生率较高的虚弱老年患者的家庭照顾者和医生治疗目标的类型，并确定家庭照顾者和医生在主要治疗目标上的一致程度。对象和方法：我们调查了200名连续的老年人的家庭照顾者和医生，他们最初是在一家大型教学医院的门诊老年评估中心接受评估的。结果：家庭照顾者和医生通常认为最重要的目标是日常功能(61[31%]家庭照顾者，81[41%]医生)，行为和情感健康(56[28%]家庭照顾者，50[25%]医生)，以及安全性(40[20%]家庭照顾者，29[15%]医生)。虽然有相当大比例的家庭照顾者和医生对至少有一个目标(157[79%])共享至少一个目标(157[79%])，但在有或没有个别目标类别上的一致性很差(Kappas从-0.19到0.28)，对最重要的目标的一致性也很差(Kappa 0.20)。结论：研究现场家庭照顾者和医生对患者的治疗目标的一致程度很低。这些结果表明，家庭照顾者和医生之间的接触可能需要改善。需要进一步的研究，以评估在其他环境中是否发现缺乏共识，是否随着时间的推移而持续存在，酸是否影响目标的实现和最佳健康结果。(C)2001年，由Excerpta Medica，Inc.
PURPOSE: Establishing shared treatment goals for patients may improve the quality of care by facilitating achievement of appropriate and desired outcomes. The purpose of this study was to describe types of family caregiver and physician treatment goals for frail elderly patients who had a high prevalence of cognitive impairment, and to ascertain the level of agreement between family caregivers and physicians on principal treatment goals. SUBJECTS ANDMETHODS: We surveyed family caregivers and physicians for 200 consecutive older adults who were initially evaluated at the outpatient geriatric assessment center of a major teaching hospital. Treatment goals for patients were measured after a comprehensive geriatric assessment.RESULTS: Goals commonly chosen as most important by family caregivers and physicians pertained to day-to-day functioning (61 [31%] family caregivers, 81 [41%] physicians), behavior and emotional health (56 [28%] family caregivers, 50 [25%] physicians), and safety (40 [20%] family caregivers, 29 [15%] physicians). Although a substantial proportion of family caregiver and physician pairs shared at least one goal (157 [79%] of 200), agreement on presence or absence of individual categories of goals was poor (kappas from -0.19 to 0,28), and agreement on the most important goal was also poor (kappa 0.20).CONCLUSIONS: Agreement on treatment goals between family caregivers and physicians for patients at the study site was low. These results suggest that encounters between family caregiver and physician may need improvement. Further research is needed to assess whether Lack of agreement is found in other settings, persists over time, acid affects achievement of goals and optimal health outcomes. (C) 2001 by Excerpta Medica, Inc.