Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA; School of Nursing, University of Wisconsin, Madison, WI, USA.
Patient Educ Couns. 2020 Jul;103(7):1428-1434. doi: 10.1016/j.pec.2020.02.022. Epub 2020 Feb 15.
Integration of patient-identified goals is a critical element of shared decision-making and patient-provider communication. There is limited information on the goals of patients with multiple medical conditions and high healthcare utilization. We aimed to identify and categorize the goals described by "high-need, high-cost" (HNHC) older patients and their caregivers.
Using conventional content analysis, we used data from interviews conducted with 17 HNHC older patients (mean age 72.5 years) and 4 caregivers.
HNHC older patients and their caregivers used language such as "hopes, wishes, and wants" to describe their goals, which fell into eight categories: alleviating discomfort, having autonomy and control, decreasing treatment burden, maintaining physical functioning and engagement, leaving a legacy, extending life, having satisfying and effective relationships, and experiencing security.
Our results contribute to knowledge of goals of HNHC patients and provides guidance for improving the patient-provider relationship and communication between HNHC older patients and their healthcare providers.
Our findings can inform provider efforts to assess patient goals and engage high-need, high-cost older patients in shared decision-making. Further, this study contributes to an improved understanding of HNHC older patients to support continued development of effective care models for this population.
将患者确定的目标整合到共同决策和医患沟通中是至关重要的。关于具有多种医疗状况和高医疗保健利用率的患者的目标信息有限。我们旨在确定和分类“高需求、高成本”（HNHC）老年患者及其照顾者所描述的目标。
使用常规内容分析，我们使用了对 17 名 HNHC 老年患者（平均年龄 72.5 岁）和 4 名照顾者进行的访谈数据。
HNHC 老年患者及其照顾者使用“希望、愿望和需求”等语言来描述他们的目标，这些目标分为八个类别：缓解不适、拥有自主权和控制、减轻治疗负担、维持身体功能和参与、留下遗产、延长生命、拥有满意和有效的关系以及体验安全。
我们的研究结果有助于了解 HNHC 患者的目标，并为改善医患关系以及 HNHC 老年患者及其医疗保健提供者之间的沟通提供指导。
我们的研究结果可以为评估患者目标和让高需求、高成本的老年患者参与共同决策的提供者提供信息。此外，本研究有助于更好地了解 HNHC 老年患者，以支持为这一人群继续开发有效的护理模式。
