Avoidance hierarchies and preferences for anticoagulation-semi-qualitative analysis of older patients' views about stroke prevention and the use of warfarin

被引：53

作者：

Fuller, R ^{[1
]}

Dudley, N

Blacktop, J

机构：

[1] Gen Infirm, Med Dept Elderly, Leeds LS1 3EX, W Yorkshire, England

[2] St James Univ Hosp, Elderly Serv, Leeds LS9 7TF, W Yorkshire, England

[3] Univ Huddersfield, Sch Human & Hlth Sci, Huddersfield HD1 3DH, W Yorkshire, England

来源：

AGE AND AGEING | 2004年 / 33卷 / 06期

关键词：

stroke; anticoagulation; risk; patient preferences; elderly;

D O I：

10.1093/ageing/afh202

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objective: To examine older patients' preferences regarding the use of warfarin to prevent atrial fibrillation related strokes when faced with cumulative probabilities of treatment risk and benefit. Design: A semi-qualitative researcher administered questionnaire and interview. Subjects: 81 patients attending a general elderly medicine outpatient clinic. Results: Up to 50% of participants would decline warfarin treatment when shown both cumulative benefits of stroke risk reduction and risk of intracerebral haemorrhage. Principal themes highlighted concepts of gambling and trade offs relating to risk and benefit. Attitudes about stroke and negative perceptions of intracerebral haemorrhage were major contributory themes in the decision to refuse warfarin treatment. Conclusion: Older people use very individualistic health beliefs in judging how to trade risks to preserve quality of life. Carefully explaining risk information and listening to elders' views and reasoning is likely to result in a more informed choice regarding the use of anticoagulation in stroke prevention.

引用

页码：608 / 611

页数：4

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