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Improving decision-making for feeding options in advanced dementia: a randomized, controlled trial.改善晚期痴呆症喂养选择决策的研究：一项随机对照试验。
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Sources of stress for family members of nursing home residents with advanced dementia.养老院中晚期痴呆患者家属的压力源。
Alzheimer Dis Assoc Disord. 2012 Jul-Sep;26(3):254-9. doi: 10.1097/WAD.0b013e31823899e4.
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Decision aids for people facing health treatment or screening decisions.为面临医疗治疗或筛查决策的人们提供的决策辅助工具。
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Decisional conflict and regret: consequences of surrogate decision making for the chronically critically ill.决策冲突和遗憾：代理决策对慢性重病患者的后果。
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Collaborative and supervisory relationships between attending physicians and advanced practice nurses in long-term care facilities.长期护理机构中主治医生与高级执业护师之间的协作和监督关系。
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Terminal hospitalizations of nursing home residents: does facility increasing the rate of do not resuscitate orders reduce them?养老院居民的临终住院治疗：增加不复苏医嘱的比例是否会减少他们的临终住院治疗？
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Perspectives of community members regarding tube feeding in patients with end-stage dementia: findings from African-American and Caucasian focus groups.社区成员对终末期痴呆患者管饲的看法：非裔美国人和白种人焦点小组的研究结果。
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医疗服务人员配置对决策辅助干预的影响。

Provider staffing effect on a decision aid intervention.

作者信息

Ersek Mary, Sefcik Justine S, Lin Feng-Chang, Lee Tae Joon, Gilliam Robin, Hanson Laura C

机构信息

Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.

出版信息

Clin Nurs Res. 2014 Feb;23(1):36-53. doi: 10.1177/1054773812470840. Epub 2013 Jan 3.

DOI:10.1177/1054773812470840
PMID:23291316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4393653/
Abstract

This study examined the association between Nurse Practitioner (NP) and Physician Assistant (PA) staffing in nursing homes and the effect of a decision aid regarding feeding options in dementia on the frequency of surrogate-provider discussions and on surrogates' decisional conflict. We compared these outcomes for facilities that had no NPs/PAs, part-time-only NP/PA staffing, and full-time NP/PA staffing. The sample included 256 surrogate decision makers from 24 nursing homes. The decision aid was associated with significant increases in discussion rates in facilities with part-time or no NP/PA staffing (26% vs. 51%, p < .001, and 13% vs. 41%, p < .001, respectively) and decreases in decisional conflict scores (-0.08 vs. -0.047, p = .008, and -0.30 vs. -0.68, p = .014, respectively). Sites with full-time NP/PA staffing had high baseline rates of discussions (41%). These findings suggest that the decision aid and full-time NP/PA staffing can enhance surrogate decision making in nursing homes.

摘要

本研究调查了疗养院中执业护士（NP）和医师助理（PA）的人员配备情况，以及一项关于痴呆症患者喂食选择的决策辅助工具对替代提供者讨论频率和替代者决策冲突的影响。我们比较了没有NP/PA、仅有兼职NP/PA人员配备以及全职NP/PA人员配备的疗养院的这些结果。样本包括来自24家疗养院的256名替代决策者。该决策辅助工具与兼职或无NP/PA人员配备的疗养院中讨论率的显著提高相关（分别为26%对51%，p < .001，以及13%对41%，p < .001），且与决策冲突得分的降低相关（分别为-0.08对-0.047，p = .008，以及-0.30对-0.68，p = .014）。全职NP/PA人员配备的疗养院基线讨论率较高（41%）。这些发现表明，该决策辅助工具和全职NP/PA人员配备可以增强疗养院中的替代决策制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3564/4393653/e24d373b454e/nihms677841f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3564/4393653/e24d373b454e/nihms677841f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3564/4393653/e24d373b454e/nihms677841f1.jpg