Abstract:
OBJECTIVES:To determine how do-not-hospitalize (DNH) orders are interpreted and used in nursing homes (NHs) once they are in place. DESIGN:Qualitative study using in-depth semi-structured interviews performed from December 2013 to April 2014. SETTING:Eight skilled nursing facilities in Connecticut that ranked in the top 10% or bottom 10% in hospitalization rates from 2008 to 2010. PARTICIPANTS:Nursing facility staff members (N = 31). MEASUREMENTS:A multidisciplinary team performed qualitative content analysis. The constant comparative method was used to develop a coding structure and identify themes. RESULTS:DNH orders were uncommon at low- and high-hospitalizing facilities. Participants reported that they did not interpret these orders literally. A DNH order was not a prohibition against hospitalization but was understood to have a variety of exceptions. These orders functioned primarily as a signal that hospitalization should be questioned and discussed with the family when an acute event occurred. CONCLUSION:In-the-moment discussions about hospitalization are still necessary even when a DNH order is in place. Work to reduce potentially burdensome NH-hospital transfers needs to focus not just on eliciting preferences in advance, but also on preparing residents and their families to make the best decisions about hospitalization when the time comes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Cohen AB,Knobf MT,Fried TRdoi
10.1111/jgs.14879subject
Has Abstractpub_date
2017-07-01 00:00:00pages
1573-1577issue
7eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章abstract::Measurements were made of the overnight mobility of a group of elderly hospital patients whose clinical status had been assessed using the Norton clinical assessment score. The number of movements on the first two nights after admission differed from subsequent nights. There was a significant correlation between mobil...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04903.x
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVES:To determine whether the occurrence of depression predicts physical disability in older people. DESIGN:A longitudinal epidemiological study with a follow-up of 5 years. SETTING:A comparison between depressed and nondepressed participants. PARTICIPANTS:The series consisted of the persons who participated i...
journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
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更新日期:2015-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01162.x
更新日期:2007-05-01 00:00:00
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更新日期:2005-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2010.02904.x
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abstract:BACKGROUND:The impact of parkinsonism on survival in older persons independent of dementia is not well understood. METHODS:Participants in the clinical examination of the Canadian Study of Health and Aging who had parkinsonism and were older than age 65 were identified. The impact of parkinsonism on 5-year survival wa...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2000.tb04701.x
更新日期:2000-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1998.tb02540.x
更新日期:1998-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01261.x
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVES:To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS:Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREME...
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更新日期:2018-01-01 00:00:00
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doi:10.1111/j.1532-5415.2008.01948.x
更新日期:2008-10-01 00:00:00
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doi:10.1111/jgs.15244
更新日期:2018-03-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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journal_title:Journal of the American Geriatrics Society
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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