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老年麻醉评估(AGE):一种关于量身定制术前干预措施的多学科方法的关怀伦理视角。

Anesthesia Geriatric Evaluation (AGE): A Care-Ethical Perspective of a Multi-Disciplinary Approach for Tailored Preoperative Interventions.

作者信息

Pel E L, van Wijngaarden E, van Dongen E P A, Noordzij P G

机构信息

University of Humanistic Studies, Utrecht, The Netherlands.

St. Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Gerontol Geriatr Med. 2019 Sep 16;5:2333721419876126. doi: 10.1177/2333721419876126. eCollection 2019 Jan-Dec.

Abstract

Frailty is considered to be an important risk factor for mortality in hospitalized patients. This study evaluates a preoperative frailty-screening tool called Anesthesia Geriatric Evaluation (AGE). Research into the concept of frailty, with a focus on multidisciplinary team meetings, may provide further insight for health care professionals in the understanding of frailty in everyday care situations. The research method chosen for this research is QUAGOL: Qualitative Analysis Guide of Leuven, which aims to reconstruct the story of the participants on a theoretical level and analyze the concepts found. The following themes illustrate the analyzed concepts found: competence, resilience, sharing responsibility, broad frame of reference, obligation, and significance. AGE seems to create more awareness among health care professionals about frailty and tries to involve patients in their care process by making them aware of their abilities, motivation, and involving them in decisions to be made. This study shows that a shared decision-making process for surgical patients is often difficult to accomplish since AGE is still a paternalistic process of a multidisciplinary team with a medical perspective.

摘要

衰弱被认为是住院患者死亡的一个重要风险因素。本研究评估了一种名为老年麻醉评估(AGE)的术前衰弱筛查工具。对衰弱概念的研究,重点关注多学科团队会议,可能会为医疗保健专业人员在日常护理情况下理解衰弱提供进一步的见解。本研究选择的研究方法是鲁汶定性分析指南(QUAGOL),其目的是在理论层面重构参与者的故事并分析所发现的概念。以下主题阐述了所发现的经过分析的概念:能力、恢复力、分担责任、广泛的参照框架、义务和意义。AGE似乎能提高医疗保健专业人员对衰弱的认识,并试图通过让患者了解自己的能力、动机并让他们参与决策,使患者参与到自身的护理过程中。这项研究表明,外科患者的共同决策过程往往难以实现,因为AGE仍然是一个从医学角度出发的多学科团队家长式的过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9820/6747854/d77673411e2f/10.1177_2333721419876126-fig1.jpg

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