INFORMED DECISION MAKING IN OLDER PATIENTS AND SURGEONS

老年患者和外科医生的明智决策

• 批准号: 6797233
• 负责人: WENDY LEVINSON
• 金额: $ 36.12万
• 依托单位: NATIONAL OPINION RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6797233
• 关键词: behavioral /social science research tag; clinical research; decision making; developmental psychology; geriatrics; human old age (65+); human subject; informed consent; orthopedics; patient care personnel relations; psychological aspect of aging; satisfaction

DESCRIPTION: As the population ages, elderly patients are confronted with difficult decisions about medical care. Communication between physicians and elderly patients is critical in helping patients make informed choices particularly about major interventions, like surgery. Communication to help patients make informed choices is not only imperative from an ethical and legal perspective, but effective communication between physicians and patients can improve the outcomes of care and patient satisfaction. This proposal builds on prior work by the investigators in which they developed and tested a framework to assess the informed decision-making (IDM) conversations in routine office visits. The proposal is collaboration between the researchers and the American Academy of Orthopedic Surgeons (AAOS), a membership organization of 25,000 surgeons. The specific goals are: 1) To assess the IDM communication skills of practicing orthopedic surgeons during routine office visits with their elderly patients (>65 years). This will be done by audio taping; routine visits with 100 surgeons and 1000 patients in the Chicago area. 2) To evaluate the association between IDM performance, surgeon, patient and visit characteristics. Surgeon characteristics will include a) demographics, b) attitudes toward older patients (ageism), participatory decision-making, and fear of litigation and c) prior communication training. Patient characteristics will include a) demographics (age, gender, race, SES) b) attitudes toward participation in decision making and c) health status. Visit characteristics will include a) length of the visit and b) presence of a third person (child, spouse) in the room. 3) To evaluate the association between surgeons IDM and patient satisfaction. Focus groups of elderly patients will review previously developed IDM criteria and provide input to ensure the criteria are "elder sensitive." 100 orthopedic surgeons' will be recruited and audio taped with 1000 patients (10 per surgeon) in the office setting. Sources of data will include a) the audiotapes, b) surgeon and patient questionnaires. The tapes will be coded to identify each decision and will be rated for the presence or absence of the appropriate IDM criteria. The association between surgeons' IDM performance, surgeon, patient, and visit characteristics will be assessed using hierarchical logistic regression. The study will be the first large data set of actual communication between surgeons and older patients and fills a major gap in knowledge about IDM with the elderly. The study also forms the scientific foundation of a major education initiative by the AAOS designed to improve the communication skills of surgeons and ultimately the care of patients.

随着人口的老龄化，老年患者面临的问题越来越多

项目成果

'I've heard wonderful things about you': how patients compliment surgeons.

“我听说过关于你的美好事情”：患者如何称赞外科医生。

• DOI: 10.1111/j.1467-9566.2010.01248.x
• 发表时间: 2010
• 期刊: Sociology of health & illness
• 影响因子: 2.9
• 作者: Hudak,PamelaL;Gill,VirginiaTeas;Aguinaldo,JeffreyP;Clark,Shannon;Frankel,Richard
• 通讯作者: Frankel,Richard

An interactional approach to conceptualising small talk in medical interactions.

• DOI: 10.1111/j.1467-9566.2011.01343.x
• 发表时间: 2011-05
• 期刊: Sociology of health & illness
• 影响因子: 2.9
• 作者: Hudak PL;Maynard DW
• 通讯作者: Maynard DW