“八十岁时我认识了自己”：身体化学习与老年人的多重用药经历及减药认知
"At 80 I Know Myself": Embodied Learning and Older Adults' Experiences of Polypharmacy and Perceptions of Deprescribing.
作者信息
Ross Alison, Gillett James
机构信息
McMaster University, Hamilton, Ontario, Canada.
出版信息
Gerontol Geriatr Med. 2019 Dec 20;5:2333721419895617. doi: 10.1177/2333721419895617. eCollection 2019 Jan-Dec.
In response to the risks of polypharmacy for older adults, there are increasing calls for the development and implementation of deprescribing programs. This article examines the forms of expertise that inform older adults' decisions about how to use medications given concerns over polypharmacy and a clinical focus on deprescribing. In-depth interviews with older adults found that diverse knowledge sources underpin decisions regarding polypharmacy and deprescribing. Findings indicate that this knowledge is formed through a lifetime of embodied learning-the production of relevant knowledge through lived experiences of the body. By way of this embodied learning, older adults possess individualized knowledge bases that inform health and health care decisions, especially regarding the use of medications. If deprescribing programs are to be embedded into standard preventive medical care of older adults, then it is valuable for health care providers to be aware of and take seriously the contribution of embodied knowledge.
针对老年人多重用药的风险，越来越多的人呼吁制定和实施减药计划。本文探讨了专业知识的形式，这些知识为老年人在考虑多重用药问题以及临床关注减药的情况下，如何使用药物的决策提供依据。对老年人的深入访谈发现，关于多重用药和减药的决策有多种知识来源作为支撑。研究结果表明，这些知识是通过一生的身体学习形成的——通过身体的生活经历产生相关知识。通过这种身体学习，老年人拥有个性化的知识库，这些知识库为健康和医疗保健决策提供依据，尤其是关于药物使用的决策。如果要将减药计划纳入老年人的标准预防性医疗保健中，那么医疗保健提供者了解并认真对待身体知识的贡献是很有价值的。
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