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老年病医生和初级保健医生治疗多病共存老年患者方法的问卷调查。

Questionnaire survey of geriatricians and primary care physicians' approaches to treating older patients with multimorbidity.

机构信息

Department of R&D Innovation for Home Care Medicine, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan.

Department of General Internal Medicine, Hyogo Medical University, School of Medicine, Nishinomiya, Japan.

出版信息

Geriatr Gerontol Int. 2023 Aug;23(8):628-638. doi: 10.1111/ggi.14638. Epub 2023 Jul 11.

Abstract

AIM

Geriatricians and primary care physicians in Japan are expected to provide care to older patients with multimorbidity.

METHODS

A questionnaire survey was carried out to understand the current approaches to older patients with multimorbidity. A total of 3300 participants, including 1650 geriatric specialists (G) and 1650 primary care specialists (PC) were enrolled. A 4-point Likert scale was used to score the following items: diseases that cause difficulty in treatment (diseases), patient backgrounds that cause difficulty in treatment (backgrounds), important clinical factors and important clinical strategies. Statistical comparisons were made between the groups. In the Likert scale, higher scores show a greater degree of difficulty.

RESULTS

We obtained responses from 439 and 397 specialists in the G and PC, respectively (response rates 26.6 and 24.1%). The overall scores for "diseases" and "backgrounds" were significantly higher in the G than those in the PC (P < 0.001 and P = 0.018). The top 10 items in the "backgrounds" and in the "important clinical strategies" were all matched between the groups. The overall score of the "important clinical factors" was not statistically different between the groups; however, "low nutrition," "bedridden activities of daily living," "living alone" and "frailty" were found only in the top 10 items of the G, and "financial problems" was found in those of the PC.

CONCLUSIONS

Geriatricians and primary care physicians have many similarities and differences in their approaches to multimorbidity management. Therefore, there is an urgent need to establish a system in which they can share a common understanding to manage older patients with multimorbidity. Geriatr Gerontol Int 2023; 23: 628-638.

摘要

目的

日本的老年病医生和初级保健医生预计将为患有多种疾病的老年患者提供护理。

方法

进行了一项问卷调查,以了解目前对患有多种疾病的老年患者的治疗方法。共纳入 3300 名参与者,包括 1650 名老年病专家(G)和 1650 名初级保健专家(PC)。采用 4 分李克特量表对以下项目进行评分:治疗困难的疾病(疾病)、治疗困难的患者背景(背景)、重要的临床因素和重要的临床策略。对两组进行了统计学比较。在李克特量表中,得分越高表示难度越大。

结果

我们分别从 G 和 PC 中获得了 439 名和 397 名专家的回复(回复率分别为 26.6%和 24.1%)。G 组的“疾病”和“背景”总体评分明显高于 PC 组(P<0.001 和 P=0.018)。“背景”和“重要临床策略”的前 10 项在两组中均匹配。两组之间“重要临床因素”的总体评分无统计学差异;然而,“低营养”、“卧床日常生活活动”、“独居”和“虚弱”仅出现在 G 组的前 10 项中,“经济问题”出现在 PC 组的前 10 项中。

结论

老年病医生和初级保健医生在处理多种疾病管理方面有许多相似之处和不同之处。因此,迫切需要建立一个系统,使他们能够共同理解来管理患有多种疾病的老年患者。老年医学与老年病学杂志 2023 年;23:628-638。

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