Abstract:
:Quality-of-life considerations in physicians' decisions on life-sustaining therapy were explored using a patient management problem (PMP) depicting acute respiratory failure in an elderly man with chronic pulmonary disease; 205 internal medicine and family medicine physicians were interviewed. The physicians' perceptions of the patient's quality of life demonstrated marked variability. Physicians considered the patient's quality of life more often to support decisions to withhold therapy than to support decisions to use mechanical ventilation (p less than 0.01). Consideration of quality of life was associated significantly with several PMP components: interpretation of the patient's prior medical experience, management of supplementary case information, attitudes about medical responsibilities/patient rights, and estimates of the patient's survival time. The authors conclude that consideration of quality of life in making life-and-death treatment decisions may involve judgments about the value of life, and that responsible consideration requires guidelines grounded in ethical principles.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Pearlman RA,Jonsen Adoi
10.1111/j.1532-5415.1985.tb07135.xsubject
Has Abstractpub_date
1985-05-01 00:00:00pages
344-52issue
5eissn
0002-8614issn
1532-5415journal_volume
33pub_type
杂志文章abstract:OBJECTIVE:To develop and validate the Time and Change (T&C) test, a simple, standardized method for detecting dementia in a diverse older outpatient population with varying levels of education. DESIGN:A prospective cohort validation study. SETTING:Two outpatient clinics at an urban teaching hospital. PARTICIPANTS:Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01534.x
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Observation stays are increasingly common for older adults, yet little is known about the extent to which they are being used as the Centers for Medicare and Medicaid Services (CMS) originally intended for unscheduled or acute problems and whether different types of services are reflected in curre...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16441
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:To determine reference values for laboratory tests in individuals aged 85 and older. DESIGN:Cross-sectional cohort study. SETTING:International. PARTICIPANTS:Long Life Family Study (LLFS) participants (N~5,000, age: range 25-110, median 67, 45% male). MEASUREMENTS:Serum biomarkers were selected based on ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14522
更新日期:2016-11-01 00:00:00
abstract::The necessity and safety of an oral calcium (Ca) and vitamin D regimen was evaluated in a population of 66 independently living and 73 institutionalized elderly women over an 11-week winter period. The members of both groups were randomly assigned into trial and control groups. Serum Ca, creatinine, and calcidiol leve...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1990.tb05700.x
更新日期:1990-08-01 00:00:00
abstract::The contribution of frailty to human morbidity and mortality is immense. Yet it lacks a conceptual framework. By borrowing from the hypotheses provided by the thermophysicists, frailty can be understood in a way that both interrelates the relationship between form and function and provides medical science with an oper...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::Two concurrent studies of geriatric outpatients who received diagnoses of depression were conducted. In the first, patients were treated with one of two tricyclic antidepressants or with a placebo. In the second, patients were assigned to groups receiving either psychodynamic group therapy or cognitive-behavioral grou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb01987.x
更新日期:1982-11-01 00:00:00
abstract::Case examples of doctor-patient interactions are used to examine educational strategies employed by physicians to obtain compliance with medication regimens from elderly patients. The problems addressed by the physicians included the complexities of pharmaco-therapy in the elderly (the patients each presented multiple...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb06138.x
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVES:To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia. DESIGN:Cross-sectional. SETTING:Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala. PARTICIPANTS:Three hundred four community-residing adults aged 55 to 94 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04191.x
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:Patient Health Priorities Identification (PHPI) is a values-based process in which trained facilitators assist older adults with multiple chronic conditions identify their health priorities. The purpose of this study was to evaluate patients' perceptions of PHPI. DESIGN:Qualitative study using thematic anal...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15850
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:Factors specifically affecting compliance with continuous positive airway pressure (CPAP) in older patients with obstructive sleep apnea (OSA) have not been described. The purpose of this study is to determine which factors are associated with compliance and noncompliance in older patients, a growing segment...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49238.x
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To identify specific characteristics of patients, physicians, and treatment settings associated with decreased receipt of essential medications in a chronically ill, older population following a Medicaid three-prescription monthly reimbursement limit (cap). DESIGN:Quasi-experiment with bivariate and multivar...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49158.x
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVES:To determine whether metabolic syndrome is an independent predictor of decline in mobility in an elderly community sample. DESIGN:Biracial community-based prospective cohort study. SETTING:Urban and rural areas of central North Carolina. PARTICIPANTS:One thousand two hundred twenty-nine older African Amer...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00607.x
更新日期:2006-03-01 00:00:00
abstract::Caregiving can have a profound effect on the health of the caregiver, yet research on caregiving among American Indians is limited. The purpose of this study was to examine the influence of caregiving on the health-related quality of life (HRQoL) of American Indians enrolled in the Education And Research Towards Healt...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12409
更新日期:2013-09-01 00:00:00
abstract::Physicians caring for individuals with life-altering, incurable illnesses often have a desire to convey a sense of hope while also helping their patients prepare for the end of life to minimize unnecessary suffering and grief. Unfortunately, in the United States, most people receive more-aggressive treatments toward t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13392
更新日期:2015-05-01 00:00:00
abstract::The effect of age on glucose tolerance, insulin secretion, and in vivo insulin action (insulin clamp) was studied in 48 nonobese subjects, all of whom were fully ambulatory and in good general health. The observed age-related increase in fasting plasma glucose (r = 0.35, P less than 0.01) was not due to an increase in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05662.x
更新日期:1982-09-01 00:00:00
abstract:OBJECTIVE:To determine if alcohol use is a risk factor for fall injury events among community-dwelling older persons. DESIGN:Case-control study. SETTING:South Miami Beach, Florida. PARTICIPANTS:320 persons 65 or older who sought treatment at six area hospitals for injuries resulting from falls; 609 controls, matched...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb01955.x
更新日期:1992-07-01 00:00:00
abstract::A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00622.x
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVES:To investigate effects of older age, comorbidities, and physiological measures on outcomes of elderly adults requiring prolonged mechanical ventilation (PMV). DESIGN:Retrospective cohort study. SETTING:Public long-term acute care hospital (LTACH) with an active program for ventilator weaning from PMV. PAR...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12597
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:To characterize a comprehensive outline of the oral microflora related to pneumonia in older adults. DESIGN:Prospective and retrospective longitudinal study. SETTING:Community. PARTICIPANTS:Long-term hospitalized patients and people in nursing homes (343 subjects, aged > or =65). MEASUREMENTS:Subjects we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02867.x
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Coronary artery calcification (CAC) reflects the extent of coronary artery atherosclerosis. The extent of coronary artery calcification is not well described in older adults. OBJECTIVE:To determine the extent of CAC in older adults participating in a large population study of cardiovascular disease (CVD), e...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02643.x
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:To assess the effect of exposure to evidence-based medication after hospital discharge for Medicare beneficiaries with acute myocardial infarction (AMI). DESIGN:A discrete-time hazard model was used to estimate time to outcome associated with exposure to four drug classes (angiotensin-converting enzyme inhi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04165.x
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To determine the perspectives of seriously ill individuals on reasons for 30-day hospital readmission. DESIGN:A prospective qualitative study was conducted employing individual interviews conducted at bedside. SETTING:Department of Veterans Affairs Greater Los Angeles Healthcare System. PARTICIPANTS:Serio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13238
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS). DESIGN:Prospective analyses. SETTING:Thirty-nine centers. PARTICIPANTS:Seven thousand one hundred forty-nine women aged...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2008.01806.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:To determine the relationships between the biomechanical properties of shoes worn in a cohort of healthy older adults and the risk of falling. DESIGN:Nested case-control study, comparing biomechanical measurements of shoes worn by those who reported a fall with measurements of shoes worn by age- and sex-mat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52507.x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Patient activation encompasses the knowledge, skills, and confidence that equip adults to participate actively in their healthcare. Patients with hearing loss may be less able to participate due to poor aural communication. We examined whether difficulty hearing is associated with lower patient ac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15833
更新日期:2019-07-01 00:00:00
abstract::Ethical issues surrounding decisions to limit treatment often focus on dramatic and highly technical interventions, such as mechanical ventilation. Many less dramatic forms of therapy are considered routine, and ethical aspects of their use may be less closely examined. Nutritional support can be crucially important i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02009.x
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVES:To examine prevalence and resident- and site-level factors associated with potential underuse, overuse, and inappropriate use of antidepressants in older Veterans Affairs (VA) Community Living Center (CLC) residents. DESIGN:Longitudinal study. SETTING:One hundred thirty-three VA CLCs. PARTICIPANTS:Three t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03522.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. DESIGN:Systematic review and network meta-analysis. PARTICIPANTS:Individuals aged 60 and older. MEASUREMENT...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析
doi:10.1111/jgs.13395
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14910
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:The extent to which the prevalence of muscle weakness in the US population varies by different putative grip strength constructs developed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) has not been described. DESIGN:Cross-sectional analysis. SETTING:Two nationally representative c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16419
更新日期:2020-07-01 00:00:00