明确照护目标。
Identifying Goals of Care.
机构信息
School of Health and Human Sciences, Indiana University, 1050 Wishard Boulevard, RG 3034, Indianapolis, IN 46202, USA.
Division of General Medicine and Geriatrics, Palliative Care, Indiana University School of Medicine, Eskenazi Health, 640 Eskenazi Avenue, Indianapolis, IN 46202, USA.
出版信息
Med Clin North Am. 2020 Sep;104(5):767-775. doi: 10.1016/j.mcna.2020.06.002.
Abstract
Goals of care conversations are important but complex for clinicians caring for older adults. Although clinicians tend to focus on specific medical interventions, these conversations are more successful if they begin with gaining a shared understanding of the medical conditions and possible outcomes, followed by discussion of values and goals. Although training in the medical setting is incomplete, there are many published and online resources that can help clinicians gain these valuable skills.
摘要
目标关怀对话对照顾老年人的临床医生来说很重要，但也很复杂。尽管临床医生往往专注于特定的医疗干预措施，但如果从共同了解医疗状况和可能的结果开始，并随后讨论价值观和目标，这些对话会更成功。尽管在医疗环境中的培训并不完善，但有许多已发表的和在线资源可以帮助临床医生获得这些宝贵的技能。
相似文献
1
Identifying Goals of Care.明确照护目标。
Med Clin North Am. 2020 Sep;104(5):767-775. doi: 10.1016/j.mcna.2020.06.002.
2
Feasibility and Effectiveness of a Mnemonic Approach to Teach Residents How to Assess Goals of Care.一种助记方法在教授住院医师评估患者照护目标中的可行性和有效性研究。
J Palliat Med. 2019 Jun;22(6):696-701. doi: 10.1089/jpm.2018.0509. Epub 2019 Jan 31.
3
A matter of conscience.事关良心。
Am J Hosp Palliat Care. 2014 Aug;31(5):581-2. doi: 10.1177/1049909113494749. Epub 2013 Aug 5.
4
End-of-life issues in advanced dementia: Part 1: goals of care, decision-making process, and family education.晚期痴呆患者的临终问题：第1部分：护理目标、决策过程及家属教育
Can Fam Physician. 2015 Apr;61(4):330-4.
5
Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values.培训具备沟通技巧的临床医生，使其能够将医疗方案与患者价值观相匹配。
J Am Geriatr Soc. 2019 May;67(S2):S435-S441. doi: 10.1111/jgs.15709.
6
Provider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review.用于预先护理计划和护理目标讨论的医疗服务提供者工具：一项系统综述。
Am J Hosp Palliat Care. 2018 Aug;35(8):1123-1132. doi: 10.1177/1049909118760303. Epub 2018 Mar 12.
7
Developing a policy for do not resuscitate orders within a framework of goals of care.在医疗照护目标框架内制定关于“不要复苏”医嘱的政策。
Jt Comm J Qual Patient Saf. 2011 Jan;37(1):11-9. doi: 10.1016/s1553-7250(11)37002-x.
8
Clinician-Family Communication About Patients' Values and Preferences in Intensive Care Units.临床医生与患者家属在重症监护病房中就患者价值观和偏好的沟通。
JAMA Intern Med. 2019 May 1;179(5):676-684. doi: 10.1001/jamainternmed.2019.0027.
9
Shared decision-making across the specialties: Much potential but many challenges.跨专业的共同决策：潜力巨大，但挑战不少。
J Eval Clin Pract. 2019 Dec;25(6):1050-1054. doi: 10.1111/jep.13276. Epub 2019 Sep 10.
10
Goals of Care Conversations in Serious Illness: A Practical Guide.严重疾病中的关怀目标对话：实用指南。
Med Clin North Am. 2020 May;104(3):375-389. doi: 10.1016/j.mcna.2019.12.001.
引用本文的文献
1
State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women.最新综述：女性复发性单纯性尿路感染
Clin Infect Dis. 2025 Mar 17;80(3):e31-e42. doi: 10.1093/cid/ciae653.
2
Uncovering Psychosocial Contexts in Goals of Care Conversations: A Qualitative Study in a Multi-Centered Randomized Controlled Trial.揭示照护目标对话中的社会心理背景：一项多中心随机对照试验的定性研究
Clin Gerontol. 2025 Feb 17:1-8. doi: 10.1080/07317115.2025.2464023.
3
How Do Clinicians Use Quotations in Goals of Care Notes?临床医生如何在照护目标记录中使用引文？
Chest. 2025 Jun;167(6):1737-1745. doi: 10.1016/j.chest.2025.01.014. Epub 2025 Jan 21.
4
Emergency department early mortality model for patients admitted after presenting to a tertiary medical center emergency department.三级医疗中心急诊科就诊后入院患者的急诊科早期死亡模型
Acad Emerg Med. 2025 Jun;32(6):650-658. doi: 10.1111/acem.15096. Epub 2025 Jan 16.
5
Portable Medical Orders and Inpatient Cost at End of Life in Acute Myeloid Leukemia and Myelodysplastic Syndromes.急性髓系白血病和骨髓增生异常综合征临终时的便携式医疗医嘱与住院费用
JCO Oncol Pract. 2025 Jun;21(6):876-882. doi: 10.1200/OP-24-00556. Epub 2024 Dec 16.
6
Platypnea-Orthodeoxia Syndrome: Presentation of a 90-Year-Old.平卧呼吸-直立性低氧血症综合征：一位90岁患者的病例报告
Cureus. 2024 Sep 4;16(9):e68673. doi: 10.7759/cureus.68673. eCollection 2024 Sep.
7
Goals-of-care discussion in older adults: a clinical and ethical approach.老年患者的照护目标讨论：临床与伦理方法
Singapore Med J. 2024 May 1;65(5):295-301. doi: 10.4103/singaporemedj.SMJ-2023-166. Epub 2024 May 10.
8
Equity in Using Artificial Intelligence Mortality Predictions to Target Goals of Care Documentation.利用人工智能预测死亡率来确定目标医疗照护文件的公平性。
J Gen Intern Med. 2024 Nov;39(15):3001-3008. doi: 10.1007/s11606-024-08849-w. Epub 2024 Jun 10.
9
Detecting goals of care conversations in clinical notes with active learning.利用主动学习技术在临床记录中检测照护目标的对话。
J Biomed Inform. 2024 Mar;151:104618. doi: 10.1016/j.jbi.2024.104618. Epub 2024 Feb 29.
10
Health Professionals' Motivational Strategies to Enhance Adherence in the Rehabilitation of People with Lower Limb Fractures: Scoping Review.卫生专业人员促进下肢骨折康复患者遵医行为的激励策略：范围综述。
Int J Environ Res Public Health. 2023 Nov 10;20(22):7050. doi: 10.3390/ijerph20227050.
本文引用的文献
1
Interprofessional Spiritual Care Education Curriculum: A Milestone toward the Provision of Spiritual Care.跨专业精神关怀教育培训课程：提供精神关怀的里程碑。
J Palliat Med. 2020 Jun;23(6):777-784. doi: 10.1089/jpm.2019.0375. Epub 2019 Dec 31.
2
Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values.培训具备沟通技巧的临床医生，使其能够将医疗方案与患者价值观相匹配。
J Am Geriatr Soc. 2019 May;67(S2):S435-S441. doi: 10.1111/jgs.15709.
3
Concordance Between Proxy Level of Care Preference and Advance Directives Among Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial.养老院中患有晚期痴呆症的居民的代理护理偏好和预先指示之间的一致性：一项聚类随机临床试验。
J Pain Symptom Manage. 2019 Jan;57(1):37-46.e1. doi: 10.1016/j.jpainsymman.2018.09.018. Epub 2018 Sep 29.
4
Learners' Experiences During Rapid Cycle Deliberate Practice Simulations: A Qualitative Analysis.快速循环刻意练习模拟期间学习者的体验：一项定性分析
Simul Healthc. 2019 Feb;14(1):18-28. doi: 10.1097/SIH.0000000000000324.
5
An Advance Care Planning Video Decision Support Tool for Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial.一项针对患有晚期痴呆症的养老院居民的预先护理计划视频决策支持工具：一项集群随机临床试验。
JAMA Intern Med. 2018 Jul 1;178(7):961-969. doi: 10.1001/jamainternmed.2018.1506.
6
Physicians' Views on Advance Care Planning and End-of-Life Care Conversations.医生对预先医疗照护计划和临终关怀谈话的看法。
J Am Geriatr Soc. 2018 Jul;66(6):1201-1205. doi: 10.1111/jgs.15374. Epub 2018 May 23.
7
Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.美国少数族裔和种族群体中预先护理计划的促进因素和障碍：当前文献的系统综述
J Immigr Minor Health. 2018 Oct;20(5):1277-1287. doi: 10.1007/s10903-017-0670-9.
8
How Well Do Current Measures Assess the Impact of Advance Care Planning on Concordance Between Patient Preferences for End-of-Life Care and the Care Received: A Methodological Review.当前的评估方法在多大程度上能评估预先医疗照护计划对患者临终关怀偏好与所接受关怀的一致性的影响：方法学综述。
J Pain Symptom Manage. 2018 Feb;55(2):480-495. doi: 10.1016/j.jpainsymman.2017.09.008. Epub 2017 Sep 22.
9
REMAP: A Framework for Goals of Care Conversations.REMAP：照护目标对话框架
J Oncol Pract. 2017 Oct;13(10):e844-e850. doi: 10.1200/JOP.2016.018796. Epub 2017 Apr 26.
10
Effect of the Goals of Care Intervention for Advanced Dementia: A Randomized Clinical Trial.晚期痴呆症护理目标干预的效果：一项随机临床试验
JAMA Intern Med. 2017 Jan 1;177(1):24-31. doi: 10.1001/jamainternmed.2016.7031.
Zotero 插件