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决策能力评估教育。

Decision-making capacity assessment education.

机构信息

Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.

Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.

出版信息

J Am Geriatr Soc. 2021 Apr;69(4):E9-E12. doi: 10.1111/jgs.17067. Epub 2021 Feb 15.

Abstract

BACKGROUND/OBJECTIVES: As the elderly population and associated number of persons with dementia increase, so does the need for decision-making capacity assessments (DMCAs). Many healthcare professionals (HCPs), however, do not feel prepared to conduct DMCAs. We have provided 4-h DMCA workshops to HCPs since 2006 and offered physicians either a 3-h or 2-day DMCA workshop from 2013 to present. We evaluated the effectiveness of the workshops on self-reported key concepts of capacity.

DESIGN

Pre-/post-test design.

SETTING

DMCA workshops for physicians across Canada and HCPs within Alberta.

PARTICIPANTS

Two hundred and eighty-one physicians and 835 HCPs.

MEASUREMENTS

Pre-/post-workshop ratings on level of comfort with and understanding of 15 core DMCA concepts using 4-point Likert-type items.

RESULTS

For the DMCA workshops among physicians, ten 3-h workshops were held in 2014-2015 with 166 participants and seven 2-day workshops, between 2014 and 2018, with 115 participants. With respect to the self-report on core DMCA concepts, at least 62.7% (range: 62.7%-89.6%) of physician participants had higher post-workshop ratings (sign test; p < 0.001) than pre-workshop ratings for all core DMCA concepts. For the DMCA workshops among HCPs, 4-h workshops were delivered to 835 HCP participants from 2008 to 2012. At least 49.6% of participants (range: 49.6%-78.9%) had increased post-workshop ratings (sign test; p < 0.001) for all level of comfort items with and understanding of core DMCA concepts.

CONCLUSION

There is a need for DMCA training for physicians and HCPs. The content and method of the workshops are effective at enhancing self-reported level of comfort with and understanding of core DMCA concepts.

摘要

背景/目的:随着老年人口和痴呆患者人数的增加,对决策能力评估(DMCAs)的需求也在增加。然而,许多医疗保健专业人员(HCPs)觉得自己没有准备好进行 DMCAs。自 2006 年以来,我们一直为 HCPs 提供 4 小时的 DCA 研讨会,并从 2013 年至今为医生提供 3 小时或 2 天的 DCA 研讨会。我们评估了研讨会对自我报告的能力关键概念的有效性。

设计

预/后测试设计。

地点

加拿大各地的医生 DCA 研讨会和艾伯塔省的 HCPs。

参与者

281 名医生和 835 名 HCPs。

测量

使用 4 分李克特量表对 15 个核心 DCA 概念的舒适度和理解程度进行预/后工作坊评估。

结果

在 2014-2015 年期间,我们举办了 10 次 3 小时的医师 DCA 研讨会,有 166 名参与者,2014 年至 2018 年期间,我们举办了 7 次 2 天的研讨会,有 115 名参与者。关于核心 DCA 概念的自我报告,至少 62.7%(范围:62.7%-89.6%)的医师参与者在所有核心 DCA 概念上的后测评分(符号检验;p<0.001)高于前测评分。在 2008 年至 2012 年期间,我们向 835 名 HCP 参与者提供了 4 小时的 DCA 研讨会。至少 49.6%的参与者(范围:49.6%-78.9%)对所有舒适度和理解核心 DCA 概念的项目的后测评分有所提高(符号检验;p<0.001)。

结论

医师和 HCPs 需要 DCA 培训。研讨会的内容和方法有效地提高了自我报告的舒适度和对核心 DCA 概念的理解程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7110/8247986/ca7af7493a98/JGS-69-E9-g001.jpg

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