Geriatric Department, Vrinnevi Hospital, Norrköping, Sweden; Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
Patient Educ Couns. 2010 Aug;80(2):233-40. doi: 10.1016/j.pec.2009.10.026. Epub 2009 Nov 30.
To deepen the knowledge of frail elderly patients' preferences for participation in medical decision making during hospitalization.
Qualitative study using content analysis of semi-structured interviews.
Patient participation to frail elderly means information, not the wish to take part in decisions about their medical treatments. They view the hospital care system as an institution of power with which they cannot argue. Participation is complicated by barriers such as the numerous persons involved in their care who do not know them and their preferences, differing treatment strategies among doctors, fast patient turnover in hospitals, stressed personnel and linguistic problems due to doctors not always speaking the patient's own language.
The results of the study show that, to frail elderly patients, participation in medical decision making is primarily a question of good communication and information, not participation in decisions about medical treatments.
More time should be given to thorough information and as few people as possible should be involved in the care of frail elderly. Linguistic problems should be identified to make it possible to take the necessary precautions to prevent negative impact on patient participation.
深化对住院期间体弱老年患者参与医疗决策偏好的认识。
采用半结构化访谈内容分析法的定性研究。
患者参与到体弱老年患者意味着信息，而不是参与他们医疗治疗决策的意愿。他们将医院护理系统视为一个他们无法与之争论的权力机构。参与受到多种障碍的影响，例如参与他们护理的众多人不了解他们的偏好和需求，医生之间存在不同的治疗策略，医院病人周转率高，人员紧张以及由于医生不总是说患者自己的语言而导致的语言问题。
研究结果表明，对于体弱的老年患者来说，参与医疗决策主要是一个良好沟通和信息的问题，而不是参与医疗治疗决策的问题。
应该给予体弱老人更充分的信息，并尽量减少参与他们护理的人数。应确定语言问题，以便能够采取必要的预防措施，防止对患者参与产生负面影响。
