了解手术内输血决策变量:一种定性研究
Tori Lenet1, Joseph Tropiano2, Stephanie Skanes3
1Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Transfusion medicine reviews
|June 14, 2023
概括
在手术中输血红细胞 (RBC) 的变化源于麻醉师和外科医生的不同信仰. 了解这些因素是开发减少不必要输血和改善患者护理的干预措施的关键.
科学领域:
- 麻醉学 麻醉学
- 输血医学 输血医学
- 健康心理学 心理健康心理学
背景情况:
- 在手术内输血红细胞 (RBC) 中存在显著的变异性,通常仅由患者因素无法解释.
- 这种变化可能表明不必要的输血,影响患者安全和资源分配.
研究的目的:
- 探索麻醉科医生和外科医生的潜在信念,影响手术内红细胞输血决策.
- 通过结构化的理论框架,识别导致输血变化的因素.
主要方法:
- 采访了28名国际输血专家 (麻醉师和外科医生),使用理论领域框架进行了采访.
- 进行了内容分析,以识别和分类影响输血决策的信念.
主要成果:
- 确定了影响输血决策的八个关键领域,包括知识差距,专业角色,对输血后果的信念,环境因素,社会影响,行为调节需求,输血行为的性质和决策过程.
- 在几个领域内,人们注意到相互矛盾的信念和不足的证据,这有助于变化.
结论:
- 认知,社会和环境因素的复杂相互作用是手术内红细胞输血变化的基础.
- 针对这些已识别的因素,需要基于理论的干预措施来标准化输血实践,减少不必要的输血.
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