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首页> 外文期刊>Clinical medicine: journal of the Royal College of Physicians of London >Are we on the same page? Exploring the role of the geriatrician in the care of the older surgical patient from the perspective of surgeons and geriatricians
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Are we on the same page? Exploring the role of the geriatrician in the care of the older surgical patient from the perspective of surgeons and geriatricians

机译：我们在同一页上吗？从外科医生和老年医师的角度探讨老年医师在老年手术患者护理中的作用

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摘要

There is increasing recognition that the ageing population represents a challenge to existing surgical services. National reports recommend that geriatricians proactively review older surgical patients to improve care and outcomes. However, this approach has not been widely translated into practice. A qualitative study was conducted using 12 semi-structured interviews of surgeons and geriatricians to explore the role of the geriatrician in the care of older surgical patients. Participants agreed that the current system did not meet the needs of older surgical patients. Geriatricians valued their holistic way of working but these generalist skills can overlap with other specialties, seen by some as wasting resources. Three models of care were proposed, with the ownership and location of the patient as well as the role of education being the key variables. The main obstacle preventing integrated working was the concern of de-skilling the surgeons, narrowing their role to that of a technician. Other barriers included loss of autonomy; lack of evidence; and a lack of recognition of the need for a geriatrician. There is acceptance that closer working practices are necessary to meet the needs of this complex patient group but a lack of evidence, together with significant human factors, are challenges that must be addressed to realise this aim.
机译：人们日益认识到人口老龄化是对现有外科服务的挑战。国家报告建议老年医生积极检查老年手术患者，以改善护理和治疗效果。但是，这种方法尚未广泛地转化为实践。通过对12位外科医生和老年医师的半结构式访谈进行了定性研究，以探讨老年医师在照顾老年外科患者中的作用。与会者一致认为，当前的系统无法满足老年手术患者的需求。老年医生很重视他们的整体工作方式，但是这些通才技能可能与其他专业重叠，有些人认为这是浪费资源。提出了三种护理模式，其中患者的所有权和位置以及教育的作用是关键变量。阻碍集成工作的主要障碍是担心外科医生的技能低下，从而使他们的角色仅限于技术人员。其他障碍包括丧失自主权;缺乏证据;并且缺乏对老年医生需求的认识。人们已经接受必须采取更严密的工作习惯来满足这一复杂患者群体的需求，但是要实现这一目标必须解决的挑战是缺乏证据以及重大的人为因素。

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