全科医生视角下输血治疗老年慢性贫血的定性调查分析

发布时间：2018-06-13 01:43

本文选题：输血治疗 + 慢性贫血　；参考：《中国全科医学》2017年26期

【摘要】：背景目前尚没有专门针对老年慢性贫血患者的输血治疗指南。在法国,当全科医生认为必须对此类患者采用输血治疗时,会联系医院的专科医生为患者安排输血。方法研究对象为20名法国全科医生。对每名全科医生对输血方式的态度进行半结构化访谈。每场访谈均被录音、记录、按主题归纳,然后,由2名研究者对其进行分析和总结,并将所记录的评论进行分类。结果全科医生为此类患者进行输血治疗的标准为血红蛋白水平8 g/dl及合并心脏病。此外,一些老年病,如认知障碍或不能自理,也被视为需要输血治疗,这是由于患者的体质过于虚弱,或其他有限的治疗方法会导致患者预期寿命减少。由于担忧患者可能因贫血而导致的死亡,也促使全科医生采取输血治疗。对于输血治疗,全科医生听取了患者家属的意见,但并没有常规听取患者意见。专科医生也很少参与到为患者的输血治疗中。全科医生对是否采取输血治疗存在矛盾:一方面输血可对患者产生较好疗效,但另一方面,由于疗效短暂,输血治疗价值不大。结论为老年慢性贫血患者是否采取输血治疗需考虑多方因素,但全科医生更倾向于独自做出决策,有时会参考患者家属意见。提前制定护理计划能有助于患者参与治疗决策。
[Abstract]:Background there are no guidelines for blood transfusion therapy for elderly patients with chronic anemia. In France, when a general practitioner deems it necessary to treat such patients with blood transfusions, they contact hospital specialists to arrange blood transfusions for patients. Methods Twenty French general practitioners were studied. A semi-structured interview was conducted on each GP's attitude towards blood transfusion. Each interview was recorded, summarized according to the topic, and then analyzed and summarized by two researchers, and the recorded comments were classified. Results the standard of blood transfusion for these patients was hemoglobin level 8 g/dl and heart disease. In addition, some geriatric diseases, such as cognitive impairment or inability to take care of themselves, are also considered to require blood transfusion treatment because patients are too weak or other limited treatments can lead to reduced life expectancy. Fears that patients may die from anaemia have also prompted general practitioners to take blood transfusions. For blood transfusion, the general practitioner listened to the patient's family, but did not routinely listen to the patient. Specialists are also rarely involved in the treatment of blood transfusions for patients. On the one hand, blood transfusion can produce better effect on patients, but on the other hand, because of the short curative effect, the value of blood transfusion treatment is not great. Conclusion in elderly patients with chronic anemia, many factors should be considered, but general practitioners tend to make decisions on their own, and sometimes refer to the opinions of the family members of the patients. Early care planning can help patients participate in treatment decisions.
【分类号】：R556

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