疫情前和期间的预先护理规划实践模式
Natasha Lee1, Laura M Perry2, Michael Hoerger3
1Department of Internal Medicine, Supportive and Palliative Care, Christiana Care, Newark, Delaware, USA.
Journal of palliative medicine
|October 19, 2023
概括
随着COVID-19大流行,缓和疗法的提前护理计划 (ACP) 讨论增加了,但对患者愿望的正式文件仍然不足. 这凸显了在卫生危机期间需要改进非洲和非洲国家和地区的流程.
科学领域:
- 医疗保健基础设施 医疗保健基础设施
- 抚慰性医学是一种缓解性医学.
- 公共卫生危机 公共卫生危机
背景情况:
- 随着COVID-19的爆发,人们开始对医疗保健系统进行批判性评估,特别是事先医疗计划 (ACP).
- 了解门诊息疗法 (PM) 中的ACP实践至关重要,特别是在公共卫生紧急情况下.
- 之前的研究还没有完全探索在PM设置中COVID-19大流行期间的ACP趋势.
研究的目的:
- 评估在COVID-19爆发前,爆发期间和爆发后,在门诊息医学实践中ACP讨论和正式文件的频率.
- 为了确定与COVID-19流行病相关的ACP实践的变化.
- 为在卫生危机期间优化ACP提供见解.
主要方法:
- 在门诊息医学诊所对患者的回顾性图表审查.
- 在COVID-19爆发前 (2019年11月至2020年2月) 和COVID-19爆发期间/后 (2020年3月至4月) 期间,ACP讨论频率和正式文档的比较.
- 统计分析,包括赔率比率,以确定ACP讨论的可能性.
主要成果:
- 在COVID-19爆发后的时期,与爆发前相比,事先的护理计划讨论显著增加.
- 手术期间和手术后的患者更有可能讨论医疗授权权 (OR=1.78,p=0.045) 和首选代码状态 (OR=2.82,p<0.001).
- 尽管讨论增加了,但反映了患者对ACP的愿望的正式文件的创建显著缺乏.
结论:
- 随着COVID-19大流行,门诊息医学环境中的预先护理规划对话增加了.
- 虽然ACP讨论有所增加,但将这些对话转化为正式的法律文件需要改进.
- 这些发现可以为加强在公共卫生紧急情况和常规息护理期间的ACP利用和文档的战略提供信息.
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