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探索为全面膝关节关节整形手术决策过程提供信息的适当性标准:一项解释性描述性研究

Lissa Pacheco-Brousseau¹, Stéphane Poitras¹, Marylène Charette²

¹School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Journal of evaluation in clinical practice

|July 6, 2023

概括

障碍阻碍了霍克的适宜性标准用于全膝关节整形术 (TKA) 的使用. 需要量身定制的干预措施来改善TKA决策和患者护理.

科学领域:

整形外科手术整形外科手术
医疗保健服务研究医疗服务研究
患者的决策能力

背景情况:

霍克的适当性标准指导了基于骨关节炎症状,证据,保守治疗试验,患者期望,风险效益分析和手术准备的全膝关节整形术 (TKA) 决策.
了解在临床实践中应用这些标准的障碍和促进因素对于优化TKA利用至关重要.

研究的目的:

探索在实施霍克的适宜性标准时遇到的障碍和促进者TKA在膝关节骨关节炎的成年人.
确定影响在临床环境中采用已建立的TKA适当性准则的因素.

主要方法:

在一个学术医院进行了一项解释性描述性定性研究.
与9名医疗保健专业人员和14名成人TKA患者进行了半结构化采访.
数据使用诱导性主题分析进行分析,并映射到实施研究综合框架的领域.

主要成果:

常见的障碍包括难以评估标准,患者依赖临床医生的决定,对保守治疗的限制,隐性主观评估和推迟的TKA信息.
还确定了医疗保健系统的因素,如缺乏及时的TKA接入和对改变当前TKA流程的抵抗.
一个单一的促进者注意到的是,证据和买入可以推动计划变化.

结论:

在临床实践和医疗保健系统中存在重大障碍,阻碍了TKA适当性标准的一致应用.
鉴定到有限的促进者表明需要有针对性的干预措施来解决已识别的障碍.
制定量身定制的干预措施对于加强在TKA决策中有效使用霍克合适性标准和改善患者治疗结果至关重要.

关键词:

这是适当的适当性.障碍物和促进者.在决策过程中做出决定.实施实施实施实施实施.使用知识使用知识.整体膝关节关节整形手术

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