意识到医生在维持生命护理决策中的共同决策
Dalyong Kim1, Hyun Jung Lee1, Soo-Young Yu2
1Division of Hematology & Medical Oncology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
Journal of hospice and palliative care
|September 7, 2023
概括
医生报告使用共享决策 (SDM) 进行维持生命治疗 (LST) 选择. 然而,时间限制限制了足够的SDM,表明需要在临床实践中改进模型.
科学领域:
- 医学伦理 医学伦理
- 临床交流 临床沟通
- 抚慰性护理是一种缓解性护理.
背景情况:
- 有效的沟通对于终身护理至关重要.
- 讨论终身护理和维持生命治疗 (LST) 在临床实践中提出了挑战.
研究的目的:
- 为了调查医生行为在共享决策 (SDM) 生命维持治疗 (LST) 决策.
- 分析临床环境中关于LST的决策是如何做出的.
主要方法:
- 基于文献审查和专家咨询,制定了一个问卷.
- 该调查的目标是治疗末期癌症患者的内科住院医生和血液学家/医疗瘤学家.
主要成果:
- 在202名受访者中,88.6%的人认为LST决策是SDM的结果,他们引用了充分的解释,患者的自主权和足够的决策时间.
- 医生仅在38.1%的病例中报告了足够的SDM实践,时间压力是主要的障碍 (89.6%).
- 护理人员 (57.4%) 对决策过程的预期满意度最高,其次是医生 (49.5%) 和患者 (41.1%).
结论:
- 尽管医生们对 SDM 实践的看法不同,但其在临床环境中得到满意的实施却很少见.
- 需要一个结构化的模型,以便在终身护理中正确实施SDM.
- 需要进一步的合作研究来开发一个有效的SDM模型.
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