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Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 22, 2010
治療の適切性に関する医師の判断に対する結果の影響
R A Caplan1, K L Posner, F W Cheney
1Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA 98111.
JAMA
|April 17, 1991
まとめ
永久的な傷害は,ケアが適切であると認識されるものに大きく影響します. 麻酔医は,治療が永久的な結果に対して適切でないと評価し,医療レビューにおける結果の重度のバイアスを強調した.
科学分野:
- 医療倫理 医療倫理について
- 患者の安全性について
- アネステシオロジー アネステシオロジー
背景:
- 医療の適切さを評価することは,医療の質の向上にとって極めて重要です.
- 患者の治療結果の重度がケア判断に与える影響は完全に理解されていません.
- アネステシオロジーは,有害事象とその因果関係を研究するための文脈を提供します.
研究 の 目的:
- 永続的な傷害は,一時的な傷害と比較して,不適切なケアとして評価される可能性が高いかどうかを調査する.
- 麻酔の結果の重度が治療の適切性に関する判断に影響を与えるかどうかを判断する.
主な方法:
- 112人の麻酔医が,麻酔による悪影響の匿名化された21件の症例をレビューした.
- 症例は,マッチングされたペアで提示され,結果の重度 (一時的対永久的) でのみ異なった.
- 審査員は,研究の意図を知らずに,介護の適切性 (適切,不適切,判断不可能) を評価した.
主要な成果:
- 結果の重症度とケア適度度評価の間の有意な逆相関は,症例の71%で発見されました.
- 適切な介護の評価は,結果が一時的から永久に変化したとき,31%減少しました.
- 適切な介護の評価は,結果が永久から一時的に変化したとき,28%増加しました.
結論:
- 副作用の重さは,医療の適切さに対する認識に大きな影響を与えます.
- 医師のレビュー者は,患者の結果が前回のケアに対する判断に影響を与える場合,結果バイアスを示す可能性があります.
- このバイアスは,医療ミス訴訟,ピアレビュー,医療における品質評価に影響を及ぼします.
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