紧急医疗和息护理临床医生报告的代码状态对话方法的差异:一种混合方法研究
Kei Ouchi1,2,3,4, Thidathit Prachanukool1,2,5, Emily L Aaronson2,6
1Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
概括
紧急医疗和息护理临床医生对代码状态对话的方法不同. 息治疗专注于患者的价值观,而紧急医疗则优先考虑由于时间限制而直接的直接性.
科学领域:
- 医学伦理 医学伦理
- 抚慰性护理是一种缓解性护理.
- 紧急医疗 紧急医疗
背景情况:
- 在急性健康恶化期间,对重病患者来说,代码状态讨论是例行的.
- 紧急医疗和息护理临床医生在这些对话中使用的方法还不太清楚.
- 这项研究旨在探索这些临床医生如何进行代码状态对话的差异.
研究的目的:
- 阐明紧急医疗和息治疗临床医生在代码状态对话中使用的方法.
- 了解他们不同方法背后的原因.
- 为了比较基于价值的与基于程序的询问策略.
主要方法:
- 在三个学术医疗中心进行了一项连续解释性的混合方法研究.
- 临床医生完成了调查,评估他们使用基于价值和基于程序问题的可能性.
- 半结构面试与调查受访者的一个子集进行了深入的逻辑探索.
主要成果:
- 观察到方法的显著差异:91%的息护理临床医生询问生活质量,而59%的急诊医学临床医生.
- 息护理临床医生强调基于价值的问题,以了解患者的目标.
- 紧急医疗临床医生发现,在紧急情况下,基于价值的问题是模糊的和耗时的.
结论:
- 紧急医疗和息护理临床医生在代码状态对话中采用不同的策略.
- 这些不同的理由很可能受到各自的临床环境和经验的影响.
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