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当患者经历了困难的生活事件时,外科医生是否会推迟提供自由裁量手术?
Nneoma O Duru1, Tom J Crijns1, David Ring1
1Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
Journal of evaluation in clinical practice
|June 7, 2023
概括
外科医生不太可能为患有最近困难生活事件 (DLE) 的患者提供自由裁量手术,这表明要优先考虑心理和社会健康. 这可能会导致手术考虑延迟,并增加寻求支持的转诊.
科学领域:
- 整形外科手术 整形外科手术
- 健康心理学 心理健康心理学
- 医疗决策的制定 医疗决策的制定
背景情况:
- 对于任意手术的外科医生决策显示出显著的变化.
- 这种变化可能受到外科医生对患者心理和社会健康因素的认识的影响.
- 了解这些影响对于公平的外科护理至关重要.
研究的目的:
- 为了调查患者最近的困难生活事件 (DLE) 和外科医生决定推迟自由裁量手术之间的关联.
- 确定DLE是否会影响外科医生对心理和社会健康转诊的建议.
- 探索影响手术治疗产品的患者和外科医生因素.
主要方法:
- 一个基于调查的实验,涉及手和上肢外科医生.
- 患者场景特征的随机化包括人口统计,症状,社会经济地位和DLE.
- 分析使用多级物流回归来确定与外科手术提供和推相关的因素.
主要成果:
- 外科医生不太可能为在过去一年中患有DLE的患者,女性和那些没有创伤诊断的患者提供自由裁量手术.
- 心理和社会健康支持的转诊与症状强度,功能限制,心理困扰 (担忧/绝望) 和DLE相关.
- 最近的DLE是推迟进行手术考虑的一个重要因素.
结论:
- 最近的DLE和延迟的手术报价之间的关联表明,外科医生可能会优先考虑患者的心理和社会福祉.
- 这一发现突显了患者的生活环境和手术治疗建议之间的复杂相互作用.
- 进一步的研究可以探索将心理和社会健康考虑纳入外科手术实践的最佳方法.
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