A BROADER ROLE FOR ADVANCE MEDICAL PLANNING
A BROADER ROLE FOR ADVANCE MEDICAL PLANNING
复制标题
DOI：
10.7326/0003-4819-123-8-199510150-00009
复制
发表时间：
1995-10-15
影响因子：
39.2
通讯作者：
GILLICK, MR
中科院分区：
文献类型：
--
作者：
GILLICK, MR
对未来疾病的预先计划应从无能情况下的医疗护理扩大到对老年人的所有医疗护理。为了有效地进行计划，患者需要对他们的整体医疗状况进行评估：他们是健壮、虚弱、精神错乱还是垂死。考虑到他们的潜在地位，他们需要了解积极治疗经常产生的各种并发症。鉴于他们的情况和他们承受医疗干预的能力的信息，患者和他们的医生需要制定广泛的医疗保健目标。实施这一计划有很大的障碍，但来自患者的压力、医疗实践中产生规划激励的结构性变化以及教育战略，包括录像访谈和角色扮演练习，都可以促进这种形式的预防医学。
Advance planning for future illness should be broadened from medical care in the event of incompetence to all medical care for the elderly. To plan effectively, patients need an assessment of their overall medical condition: whether they are robust, frail, demented, or dying. They need to understand the kinds of complications often engendered by aggressive treatment, given their underlying status. Given information about their circumstances and their capacity to withstand medical interventions, patients, together with their physicians, need to formulate broad goals for medical care. There are significant barriers to implementing this scheme, but pressure from patients, structural changes in the practice of medicine that create incentives for planning, and educational strategies, including videotaped interviews and role-playing exercises, can facilitate this form of preventive medicine.