Kunicki Zachary J, Madrigal Caroline, Quach Lien T, Riester Melissa R, Jiang Lan, Duprey Matthew S, Bozzay Melanie, Zullo Andrew R, Singh Mriganka, McGeary John, Wu Wen-Chih, Rudolph James L
Department of Psychiatry and Human Behavior, 12321Alpert Medical School of Brown University, Providence, RI, USA.
VA Center of Innovation in Long Term Services, 20100Providence VA Medical Center, Providence, RI, USA.
J Appl Gerontol. 2023 Jan;42(1):28-36. doi: 10.1177/07334648221123059. Epub 2022 Aug 26.
To encourage person-centered care, the Centers for Medicare and Medicaid require nursing homes to measure resident preferences using the Preferences Assessment Tool (PAT). No known research has examined the implications of respondent type (i.e., resident, proxy, staff) on preference importance; therefore, the purpose of this study was to compare the importance of preferences depending on which respondent completed the PAT. Participants included 16,111 Veterans discharged to community-based skilled nursing facilities after hospitalization for heart failure. A majority (95%) of residents completed the PAT compared to proxy (3%) and staff (2%). Proxy responders were both more and less likely to indicate individual preferences as important compared to residents. Staff members were consistently less likely to indicate all preferences as important compared to residents. Findings from this study emphasize the need for proxy and staff to find methods to better understand residents' preferences when residents are not able to participate in assessments.
为鼓励以患者为中心的护理,医疗保险和医疗补助服务中心要求疗养院使用偏好评估工具(PAT)来衡量居民的偏好。目前尚无研究探讨受访者类型(即居民、代理人、工作人员)对偏好重要性的影响;因此,本研究的目的是比较根据完成PAT的受访者不同,偏好的重要性有何差异。研究对象包括16111名因心力衰竭住院后出院至社区专业护理机构的退伍军人。与代理人(3%)和工作人员(2%)相比,大多数居民(95%)完成了PAT。与居民相比,代理人受访者更有可能也更不可能将个人偏好视为重要。与居民相比,工作人员始终不太可能将所有偏好都视为重要。本研究结果强调,当居民无法参与评估时,代理人和工作人员需要找到更好地理解居民偏好的方法。