当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN GERIATRICS SOCIETY期刊下所有文献 > Patient participation in medical and social decisions in Alzheimer's disease.

Patient participation in medical and social decisions in Alzheimer's disease.

Abstract：

OBJECTIVES:To analyze the preferences of people with amnestic mild cognitive impairment (aMCI) and mild dementia in Alzheimer's disease (AD) regarding different aspects of healthcare-related decisions, to correlate these findings with different measures of decision-making capacity, and to explore the views of relatives and referring physicians. DESIGN:Cross-sectional survey. SETTING:University-based memory clinic in Munich, Germany. PARTICIPANTS:One hundred people with aMCI or mild AD, their relatives (N = 99), and their referring physicians (N = 93). MEASUREMENTS:Participation preferences and decisional capacity and assessment of these measures according to relatives and physicians. RESULTS:Patients had a preference for participation in healthcare-related decisions, especially in social ones. Overall, individuals wanted their relatives to play a secondary role in decision-making. Relatives and referring physicians performed poorly in predicting the individuals' participation preferences, and relatives wanted to attribute less decision-making power to patients than the patients did themselves. Patients refrained from participation if they had lower Mini-Mental State Examination scores or were unsure about their decisional capacity. There were deficits in decision-making capacity, which mostly related to understanding of the information presented. There was only weak correlation between the different measures (patient's, relative's, and physician's estimate, MacArthur Competence Assessment Tool for Treatment) of the patients' decisional capacity. CONCLUSION:The combination of marked participation preferences and impairments in the decisional capacity of individuals with aMCI and early AD constitute an ethical and practical challenge. A thorough implementation of structured probes of the patients' decisional capacity combined with interventions that aid patients in their decision-making capability might help to overcome some of these challenges.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Hamann J,Bronner K,Margull J,Mendel R,Diehl-Schmid J,Bühner M,Klein R,Schneider A,Kurz A,Perneczky R

doi

10.1111/j.1532-5415.2011.03661.x

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

2045-52

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

杂志文章

在线工具

Patient participation in medical and social decisions in Alzheimer's disease.