Lai James M, Karlawish Jason
Department of Medicine, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT 06504, USA.
Am J Geriatr Psychiatry. 2007 Feb;15(2):101-11. doi: 10.1097/01.JGP.0000239246.10056.2e.
Assessing the capacity of patients to make decisions about their functional problems has substantial ethical, clinical, and financial implications. The growing population of older adults with cognitive impairment either in the community or in long-term care and medical facilities increase the importance of adequately assessing this capacity. This review examines the current approaches to making this assessment, demonstrates how they are incomplete, and considers potential approaches for improving these evaluations. Future research should develop and validate methods to identify patients with impaired capacity to make everyday decisions. These data will supplement functional, cognitive, and medical assessments.
评估患者对自身功能问题做出决策的能力具有重大的伦理、临床和财务意义。社区或长期护理及医疗设施中认知障碍的老年人数量不断增加,这凸显了充分评估这种能力的重要性。本综述审视了进行此项评估的当前方法,指出其不足之处,并探讨改进这些评估的潜在方法。未来的研究应开发并验证识别日常决策能力受损患者的方法。这些数据将补充功能、认知和医学评估。