在原始情境中实施预先护理计划的障碍和促进因素 - - 在耕种新地形时,在哪里寻找?
Siri Færden Westbye1, Siri Rostoft2, Maria Romøren3
1Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern, 0318, Oslo, Norway. s.f.westbye@medisin.uio.no.
BMC geriatrics
|June 23, 2023
概括
实施预先护理计划 (ACP) 需要解决系统性障碍,如时间限制和文化规范. 提高专业教育和政策制定是改善与价值观和偏好一致的以患者为中心的护理的关键.
科学领域:
- 医疗保健管理的管理
- 医学伦理 医学伦理
- 患者的自主权患者的自主权
背景情况:
- 提前护理规划 (ACP) 将医疗实践与患者的自主权,价值观和偏好保持一致.
- 尽管有证实的好处,但在全球范围内,ACP的利用不足.
- 本研究探讨了在临床,机构和政策层面对非洲和非洲国家实施的障碍和促进因素.
研究的目的:
- 识别预先护理计划 (ACP) 实施的系统性障碍和促进因素.
- 探索在不同的医疗保健环境中改善ACP的战略.
- 提供一个整体系统的方法,以加强非洲和非洲的整合.
主要方法:
- 对40名医疗保健专业人员和首席医生进行了定性采访.
- 该研究采用了探索性和灵活的定性设计.
- 主题分析遵循布劳恩和克拉克的既定策略.
主要成果:
- 关键障碍包括缺乏时间,领导力支持不足,沟通系统不佳,责任不清楚等.
- 错过的机遇和过度处理与非洲国家和地区的启动挑战有关.
- 促进者包括政策制定,公共/专业教育和标准化文档.
结论:
- 转变专业教育和临床文化对于ACP实施至关重要,特别是当患者的愿望没有法律约束力时.
- 解决有关ACP的误解 (例如,它不仅仅是关于终身护理) 是至关重要的.
- 需要实践培训,政策制定和立法,以便将患者和护理人员纳入护理规划.
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