在整节关节整形术中,骨科外科医生的优先事项和患者的期望之间缺乏对齐
Harsh N Shah1, Andrew A Barrett2, Patrick H Le3
1School of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Patient safety in surgery
|June 29, 2023
概括
接受手术的患者优先考虑结果,而不是像切口大小这样的细节,并且经常与医院指标不一致. 让患者参与护理讨论对于更好的调整至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 以患者为中心的护理
- 卫生经济学 卫生经济学
背景情况:
- 医疗保健系统越来越多地采用以患者为中心的护理模式,而不完全理解患者的价值观.
- 医生和患者的兴趣可能会有所分歧,特别是随着绩效支付倡议的兴起.
- 评估患者在手术护理中的优先事项对于将治疗与患者期望保持一致至关重要.
研究的目的:
- 在外科手术期间确定患者的基本医疗偏好.
- 将患者的优先事项与医疗保健提供者所评估的指标进行比较.
主要方法:
- 一项前性观察性研究,调查了102名初级膝关节或关节置换术后的患者.
- 分析假设情景,以衡量患者的偏好.
- 使用皮尔森基平方和单向ANOVA对抗凝血数据进行统计分析.
主要成果:
- 大多数患者 (72%) 不会为较小的切口 (≤4厘米) 支付额外费用.
- 很大一部分患者 (28%) 愿意为较小的切口支付平均1328美元.
- 患者显著偏好不使用抗凝药 (p=0.019),但避免使用特定方法的价值并不显著 (p=0.507).
结论:
- 医院和外科医生优先考虑的指标往往与患者评估的外科治疗结果不一致.
- 患者的期望和他们接受的护理之间存在着分离.
- 将患者纳入与医生和医院系统的讨论中,可以解决这些差异.
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