Mayo Ann M, Wallhagen Margaret I
Hahn School of Nursing and Health Sciences, University of San Diego, 5998 Alcala Park, San Diego, CA 92110-2492, USA.
Res Gerontol Nurs. 2009 Apr;2(2):103-11. doi: 10.3928/19404921-20090401-08.
Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research.
将有认知障碍的老年人纳入研究对于确保旨在改善护理的干预措施对所有老年人都有效而言是必要的。然而，与同意能力相关的问题引发了许多护士研究人员必须解决的难题。在保护弱势参与者的同时维护其自主性并推动重要研究进展可能具有挑战性。评估理解、领会、推理和表达选择的决策能力是确定决策能力的一个重要方面。然而，尽管这是判断决策能力的主要合理方法，但它没有考虑文化、价值观和情感的重要性。本文重点关注同意的决策能力评估、针对有认知障碍的老年人获取知情同意的建议、替代决策者的使用、使研究参与最大化的策略以及未来研究的方向。
