Suppr超能文献

应用轻度认知障碍和痴呆诊断信息披露的建议:临床医生实用指南。

Applying recommendations for diagnostic disclosure of mild cognitive impairment and dementia: Practical guidance for clinicians.

作者信息

O'Brien Kyra, Largent Emily A, Karlawish Jason

机构信息

Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

出版信息

Alzheimers Dement. 2025 Jan;21(1):e14200. doi: 10.1002/alz.14200. Epub 2024 Dec 30.

Abstract

A comprehensive evaluation for cognitive impairment should culminate with the communication of the diagnosis to patients and their care partners. This diagnostic disclosure sets the stage for subsequent care. Diagnostic disclosure for individuals with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias (ADRD) is particularly nuanced and requires a conscientious approach. Clinicians must assess patients' understanding and appreciation of symptoms, goals for the evaluation, and desire for information. Because AD/ADRD can impact patients' perceptions of their symptoms, it is recommended to include an informant or care partner for this assessment and for future care. Here, we provide guidance for addressing the complexities of AD/ADRD diagnostic disclosure to build clinicians' confidence in communicating diagnostic findings and a plan of care. HIGHLIGHTS: Diagnostic disclosure is a key part of the evaluation of cognitive impairment. The disclosure process begins at the moment a cognitive evaluation is initiated. Care partners must be included in the cognitive evaluation and diagnostic disclosure. Clinicians should use patient-centered communication for evaluation and disclosure.

摘要

对认知障碍的全面评估应以向患者及其护理伙伴传达诊断结果作为结束。这种诊断结果的披露为后续护理奠定了基础。对于因阿尔茨海默病(AD)或AD相关痴呆症(ADRD)导致认知障碍的个体,诊断结果的披露尤为微妙,需要采取审慎的方法。临床医生必须评估患者对症状的理解和认知、评估目标以及对信息的需求。由于AD/ADRD会影响患者对自身症状的认知,因此建议在此次评估及后续护理中纳入知情人或护理伙伴。在此,我们提供应对AD/ADRD诊断结果披露复杂性的指导,以增强临床医生传达诊断结果和护理计划的信心。要点:诊断结果披露是认知障碍评估的关键部分。披露过程从启动认知评估的那一刻就开始了。护理伙伴必须参与认知评估和诊断结果披露。临床医生应采用以患者为中心的沟通方式进行评估和披露。

相似文献

本文引用的文献

6
Lecanemab in Early Alzheimer's Disease.早期阿尔茨海默病中的lecanemab
N Engl J Med. 2023 Jan 5;388(1):9-21. doi: 10.1056/NEJMoa2212948. Epub 2022 Nov 29.
9
Determinants of Caregiver Burden in Early-Onset Dementia.早发性痴呆症中照顾者负担的决定因素
Dement Geriatr Cogn Dis Extra. 2021 Aug 13;11(2):189-197. doi: 10.1159/000516585. eCollection 2021 May-Aug.
10
Supported Decision Making With People at the Margins of Autonomy.支持边缘自主性人群的决策制定。
Am J Bioeth. 2021 Nov;21(11):4-18. doi: 10.1080/15265161.2020.1863507. Epub 2020 Dec 29.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验