从生活在风险中的叙述转变为生活在风险中的叙述:验证和试点测试临床决策支持工具:混合方法研究
Heather MacLeod1, Nathalie Veillette2,3, Jennifer Klein4
1Regional Geriatric Program of Eastern Ontario, Ottawa, ON, Canada.
BMC geriatrics
|May 31, 2023
概括
医疗保健专业人员可以使用"与风险相处:决策支持工具" (LwR:DST) 来帮助老年人与风险相处. 该工具改善了老年人的决策,沟通和医疗保健体验.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健决策 - - 医疗保健决策
- 风险评估 风险评估
背景情况:
- 医疗保健专业人员 (HCP) 通常优先考虑老年人的安全,而不是老年人希望在家生活.
- 对于老年人来说,需要从"生活在风险中"转变为"生活在风险中".
- 风险生活:决策支持工具 (LwR:DST) 是为了帮助医疗保健人员和老年人管理与风险生活有关的决策而开发的.
研究的目的:
- 为了验证LwR:DST.的内容和过程.
- 在医院和社区卫生保健机构试点测试LwR:DST.
- 评估LwR:DST对医疗保健工作者的决策和老年人的医疗保健经验的影响.
主要方法:
- 使用Delphi方法验证了LwR:DST的内容,其中包括71名医疗人员和17名老年人和护理人员的焦点小组.
- 医疗人员的反主要集中在内容,格式和使用说明书上.
- 老年人和护理人员对LwR:DST的沟通组件提供了反.
- 修订后的LwR:DST由14名医疗保健工作者和17名老年人/护理人员在医院和社区环境中进行试点测试.
- 进行了定量和定性分析,包括描述和主题分析.
主要成果:
- 根据专家和用户反,LwR:DST经历了两次代修订.
- 定量数据验证了LwR:DST的内容和过程.
- 定性数据为该工具的实际改进提供了信息.
- 试点测试表明LwR:DST扩大了医疗保健人员的临床思维,结构化的决策和增强的沟通.
- 医疗保健人员报告说,在风险评估和管理方面,他们的能力和舒适度增加了.
- 老年人感到被听取,理解和参与,改善了他们的医疗保健经验.
结论:
- 修订后的LwR:DST帮助医疗保健人员识别和减轻希望留在家中或返回家中的脆弱老年人的风险.
- 该工具促进了范式的转变,认识到风险是日常生活中固有的,具有积极和消极的后果.
- 未来的研究将解决临床实践中LwR:DST的实际实施挑战.
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