"Hopes and wishes": Goals of high-need, high-cost older patients and their caregivers.

Autor: Wyman MF; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: mfwyman@wisc.edu., Liebzeit D; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA; School of Nursing, University of Wisconsin, Madison, WI, USA. Electronic address: daniel.liebzeit@wisc.edu., Voils CI; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Research Service, W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA. Electronic address: voils@surgery.wisc.edu., Bowers BJ; School of Nursing, University of Wisconsin, Madison, WI, USA. Electronic address: bjbowers@wisc.edu., Chapman EN; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA. Electronic address: EChapman@uwhealth.org., Gilmore-Bykovskyi A; School of Nursing, University of Wisconsin, Madison, WI, USA; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA. Electronic address: algilmore@wisc.edu., Kennelty KA; Carver College of Medicine, University of Iowa, Iowa City, IA, USA. Electronic address: korey-kennelty@uiowa.edu., Kind AJH; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Health Services and Care Research Program, Department of Medicine, University of Wisconsin, Madison, WI, USA. Electronic address: ajk@medicine.wisc.edu., Loosen J; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: jloosen@wisc.edu., Rogus-Pulia N; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA. Electronic address: npulia@wisc.edu., Dattalo M; University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatrics Research, Education and Clinical Center (GRECC), W.S. Middleton Memorial Veterans Hospital, Madison, WI, USA. Electronic address: MDattalo@uwhealth.org.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2020 Jul; Vol. 103 (7), pp. 1428-1434. Date of Electronic Publication: 2020 Feb 15.
DOI: 10.1016/j.pec.2020.02.022
Abstrakt: Objective: Integration of patient-identified goals is a critical element of shared decision-making and patient-provider communication. There is limited information on the goals of patients with multiple medical conditions and high healthcare utilization. We aimed to identify and categorize the goals described by "high-need, high-cost" (HNHC) older patients and their caregivers.
Methods: Using conventional content analysis, we used data from interviews conducted with 17 HNHC older patients (mean age 72.5 years) and 4 caregivers.
Results: HNHC older patients and their caregivers used language such as "hopes, wishes, and wants" to describe their goals, which fell into eight categories: alleviating discomfort, having autonomy and control, decreasing treatment burden, maintaining physical functioning and engagement, leaving a legacy, extending life, having satisfying and effective relationships, and experiencing security.
Conclusion: Our results contribute to knowledge of goals of HNHC patients and provides guidance for improving the patient-provider relationship and communication between HNHC older patients and their healthcare providers.
Practice Implications: Our findings can inform provider efforts to assess patient goals and engage high-need, high-cost older patients in shared decision-making. Further, this study contributes to an improved understanding of HNHC older patients to support continued development of effective care models for this population.
(Published by Elsevier B.V.)
Databáze: MEDLINE
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