人格障碍的新视野——从忽视到老年护理的必要性。

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Richard C Oude Voshaar, Silvia D M van Dijk
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引用次数: 0

摘要

每10名老年人中就有1人患有人格障碍,其特征是行为、认知和情绪调节模式持续和不适应。考虑到人格障碍与多病和医疗保健利用的增加有关,人格障碍在老年护理中经常遇到。人格障碍患者往往得不到充分的躯体保健,原因是:(一)难以表达其实际症状和需求,(二)难以与专业人员互动,以及(三)不遵守医疗和生活方式建议。在老年护理中承认人格障碍可以改善躯体疾病的治疗效果。由于在老年人人格诊断和治疗的经验证据是稀缺的,我们总结未来的努力。首先,应优先开发涵盖年龄的诊断工具,以确保各年龄组之间的可比性,并促进整个生命周期的纵向研究。其次,基于证据的治疗方法应针对老年人量身定制。考虑到足够的内省水平,以洞察力为导向的心理疗法在以后的生活中仍然有效。支持性和冥想疗法可能更适合那些有严重认知或身体障碍的人。考虑到所需的高水平跨学科交流,当在老年团队和网络内可以确保一致的方法时,老年护理模式应该是管理这些患者复杂需求的理想选择。第三,考虑到人格障碍的动态性,老年人不应被排除在使用实时监测和个性化护理新技术的研究之外。通过解决这些差距,该领域可以改善躯体治疗结果,维护患有人格障碍的老年人的尊严和福祉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New horizons in personality disorders-from neglect to necessity in geriatric care.

Personality disorders, characterised by enduring and maladaptive patterns of behaviour, cognition and emotional regulation, affect 1 in 10 older adults. Personality disorders are frequently encountered in geriatric care considering their association with multimorbidity and increased health care utilisation. Patients with personality disorders often receive inadequate somatic health care due to (i) difficulties in expressing their actual symptoms and needs, (ii) challenging interactions with professionals, and (iii) non-compliance with medical treatment and lifestyle advice. Acknowledging personality disorders in geriatric care may improve treatment outcomes of somatic diseases. Since empirical evidence on personality diagnosis and treatment in older adults is scarce, we summarise future endeavours. First, the development of age-inclusive diagnostic tools should be prioritised to ensure comparability across age groups and facilitate longitudinal research over the lifespan. Second, evidence-based treatment approaches should be tailored to older people. Insight-oriented psychotherapies remain effective in later life considering sufficient level of introspection. Supportive and mediative therapies may better suit those with significant cognitive or physical impairments. Geriatric care models should be ideal for managing the complex needs of these patients when a consistent approach can be assured within the geriatric team as well as within the network considering the high level of interdisciplinary exchange needed. Third, considering the dynamic nature of personality disorders older adults should not be excluded from studies using novel technologies for real-time monitoring and personalised care. By addressing these gaps, the field can improve somatic treatment outcomes and uphold the dignity and well-being of older adults with personality disorders.

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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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