Morgan R, Pendleton N, Clague J E, Horan M A
Department of Geriatric Medicine, Stepping Hill Hospital, Stockport.
Br J Gen Pract. 1997 Jul;47(420):427-30.
Little is known of the nature and origins of the attitudes that older people have towards ageing, disease, and medical treatments. Several studies on older people in the community have suggested under-reporting of symptoms. There may be several reasons for this, including the possibility that some older people regard disease processes as a natural feature of ageing and, consequently, feel that medical intervention may have little to offer.
To investigate the perceptions of older people about the significance of symptoms and what action they would take in response to particular symptoms.
Thirty-three men and 77 women attending social clubs (median age 78 years) were opportunistically selected and assessed using a supervised questionnaire.
Many symptoms classically associated with common diseases were often considered to represent disease as well as to be normal for old people. Most would consult a doctor if they were to experience them. Some important symptoms, such as blackouts or paralysis of a limb, were not considered to be normal. Non-specific symptoms of psychiatric disturbances were also frequently considered normal but were not considered to represent disease. Whether or not a doctor would be consulted was often, but not always, related to whether a symptom was thought to represent a disease. Consulting a pharmacist was seldom considered appropriate.
Doctors working with elderly people need to consider how beliefs about health and disease might affect what is reported to them. Specific enquiry needs to be made about symptoms of psychiatric disturbances. These findings suggest that there is a case for increased health education at retirement age.
关于老年人对衰老、疾病及医疗治疗的态度的本质和根源,我们知之甚少。社区中针对老年人的多项研究表明,症状报告存在漏报情况。其原因可能有多种,包括一些老年人将疾病过程视为衰老的自然特征,因此觉得医疗干预可能作用不大。
调查老年人对症状重要性的看法以及他们针对特定症状会采取何种行动。
机会性选取了33名男性和77名女性(年龄中位数为78岁),他们均参加社交俱乐部,使用一份有监督的问卷对其进行评估。
许多与常见疾病典型相关的症状,通常既被认为代表疾病,也被认为是老年人的正常现象。大多数人如果出现这些症状会去看医生。一些重要症状,如昏厥或肢体瘫痪,不被认为是正常现象。精神障碍的非特异性症状也经常被认为是正常的,但不被认为代表疾病。是否会去看医生通常(但并非总是)与一种症状是否被认为代表疾病有关。很少有人认为咨询药剂师是合适的。
为老年人看病的医生需要考虑关于健康和疾病的观念可能如何影响向他们报告的情况。需要对精神障碍症状进行具体询问。这些发现表明,退休年龄有必要加强健康教育。