Influence of a values discussion on congruence between elderly women and their families on critical health care decisions
Influence of a values discussion on congruence between elderly women and their families on critical health care decisions
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DOI：
10.1300/j074v09n04_02
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发表时间：
1997-01-01
影响因子：
1.5
通讯作者：
Roberto, KA
中科院分区：
文献类型：
--
作者：
MatheisKraft, C;Roberto, KA
这项研究调查了有能力的老年妇女(N=60)与她们的代理人之前对价值观的讨论是否有助于这些代理人根据妇女的愿望做出关键的卫生保健决定。妇女被随机分配到试验组或控制组。实验处理包括在其代理人在场的情况下讨论价值指标。受试者被要求在3种心理状态下的10种情境下使用替代判断标准做出决定。在30种情境中，有27种的一致性并不高于控制组中的女性-代理配对，但在11种情境中有11种的一致性百分比更高。讨论了Kappa统计量在医疗保健协议研究中的局限性。不同心理状态的平均治疗决策得分有显著差异，表明随着心理敏锐度在情景中降低，女性更有可能拒绝推荐的治疗。
This study investigated if prior discussion of values by competent older women (N = 60) with their proxies assisted these proxies to make critical health care decisions in congruence with the desires of the women. Women were randomly assigned to experimental or control groups. Experimental treatment consisted of discussion of value indicators in the presence of their proxies. The proxies were instructed to make decisions in 10 situations across 3 mental states using the substituted judgment standard.The experimental group did not have statistically higher agreement than women-proxy pairs in the control group in 27 of the 30 situations, but they had greater percentage agreement in 11 of the situations. Limitations of the Kappa statistic in health care agreement studies were addressed. The mean treatment decision scores were significantly different across mental states, indicating as mental acuity was decreased in the scenarios, the women were more likely to refuse the recommended treatment.