Communication Skills and Decision Making for Elderly Patients With Advanced Kidney Disease: A Guide for Nephrologists
Communication Skills and Decision Making for Elderly Patients With Advanced Kidney Disease: A Guide for Nephrologists
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DOI：
10.1053/j.ajkd.2015.09.032
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发表时间：
2016-04-01
影响因子：
13.2
通讯作者：
Schell, Jane O.
中科院分区：
文献类型：
--
作者：
Koncicki, Holly M.;Schell, Jane O.
老年患者是开始透析治疗的增长最快的人群，可能从老年综合征、共存共病和总体预后的综合评估中获益。姑息治疗是一种理念，旨在改善生活质量，并协助患有严重疾病（如肾脏疾病）的患者做出治疗决策。肾脏病提供者的姑息技能可以帮助这些患者的护理。该综述为肾脏病提供者提供了4种主要姑息治疗技能，以指导治疗决策：（1）使用预后工具来识别可能从保守治疗中受益的患者，（2）向可能在透析治疗中表现不佳的患者披露预后信息，（3）结合患者目标和价值来概述治疗计划，以及（4）为病人和家属做好过渡和生命结束的准备。(C)2016年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Elderly patients comprise the most rapidly growing population initiating dialysis therapy and may derive particular benefit from comprehensive assessment of geriatric syndromes, coexisting comorbid conditions, and overall prognosis. Palliative care is a philosophy that aims to improve quality of life and assist with treatment decision making for patients with serious illness such as kidney disease. Palliative skills for the nephrology provider can aid in the care of these patients. This review provides nephrology providers with 4 primary palliative care skills to guide treatment decision making: (1) use prognostic tools to identify patients who may benefit from conservative management, (2) disclose prognostic information to patients who may not do well with dialysis therapy, (3) incorporate patient goals and values to outline a treatment plan, and (4) prepare patients and families for transitions and end of life. (C) 2016 by the National Kidney Foundation, Inc.