Old Age, Life Extension, and Geriatrics

老年、延长寿命和老年病学

• 批准号: 6785373
• 负责人: SHARON R KAUFMAN
• 金额: $ 34.09万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6785373
• 关键词: behavioral /social science research tag; clinical research; culture; decision making; dialysis therapy; extended care; family structure /dynamics; functional ability; geriatrics; health behavior; health care policy; health care quality; health care service evaluation; heart revascularization; human old age (65+); human subject; interview; kidney transplantation; liver transplantation; long term survivor; outcomes research; patient care planning; physicians; psychological values; quality of life; social support network

DESCRIPTION (provided by applicant): The goal of this 4-year qualitative anthropological study is to investigate first, how physicians, patients age 70 and over and their families make decisions regarding the use of three groups of life-extending medical procedures (cardiac bypass, angioplasty and stent; kidney and liver transplant; and renal dialysis) and how they each respond to those procedures; and second, to identify socio-cultural issues of relevance to physicians and to society regarding the growing use of life-extending medical procedures on elderly patients. This will be an empirical, ethnographic study based on the collection of data by in-depth interviews with physicians, patients and their families, and by participant-observation of support groups for cardiac and transplant patients and of physician-patient discussions where life-extending procedures are discussed. There are 4 specific aims:1) to provide a descriptive account of physician, patient, and family understandings of relationships among changing conceptions of old age, health in late life and expectations about life-extending medical care; 2) to learn how physicians in different specialties are extending the lives of their elderly patients and the values underlying their decisions; 3) to learn the structural and cultural constraints on their choices for life-extending procedures; and 4) to describe patient and family choices, knowledge and values. Coding-based qualitative data analysis will be used: cross-sectional comparison, thematic analysis, case studies, and frequencies of response. The interpretive goal is to examine in detail the social, structural and medical practices and values brought to bear on the extension of life at progressively older ages. This will be the first research that comprehensively addresses medical and lay decision-making surrounding life-extending medical procedures for older persons, and the responses and experiences of physicians, patients and families to those procedures.

描述（由申请人提供）：这项为期4年的定性人类学研究的目标是首先调查医生、70岁及以上的患者及其家属如何决定使用三组延长生命的医疗程序（心脏搭桥、血管成形术和支架;肾脏和肝脏移植;以及肾透析）以及它们各自对这些程序的反应;第二，确定与医生和社会有关的社会文化问题，这些问题与老年患者越来越多地使用延长生命的医疗程序有关。这将是一项经验性的人种学研究，其基础是通过对医生、患者及其家属的深入访谈收集数据，并通过参与观察心脏病和移植患者的支持小组以及讨论延长生命程序的医患讨论。有4个具体的目标：1）提供一个描述性的帐户医生，病人，和家庭的理解之间的关系不断变化的概念，老年，健康在晚年和期望延长生命的医疗保健; 2）了解医生在不同的专业是如何延长他们的老年病人的生命和价值观的决定; 3）了解结构和文化的限制，他们选择延长生命的程序;（4）描述患者和家属的选择、知识和价值观。将使用基于编码的定性数据分析：横截面比较、专题分析、案例研究和答复频率。解释性的目标是详细审查社会、结构和医疗实践与价值观，这些实践与价值观对逐渐老龄化的生命延长产生了影响。这将是第一项全面探讨围绕延长老年人生命的医疗程序的医疗和非专业决策以及医生、病人和家庭对这些程序的反应和经验的研究。