打破循环:使用严重疾病沟通来优化严重疾病的护理过渡规划
Tamra Keeney1, Jaclyn Shameklis2, Alexis Drutchas2
1Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA; Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA, USA; Continuum Project, Massachusetts General Hospital, Boston, MA, USA.
Journal of the American Medical Directors Association
|November 10, 2023
概括
重症疾病沟通 (SIC) 培训康复临床医生提高了对面临严重疾病的老年人管理护理过渡的信心. 这项试点计划证明了可行性和高满意度,解决了"重恋到死亡"的循环.
科学领域:
- 老年学是指老年学的学科.
- 抚慰性护理是一种缓解性护理.
- 康复医学 康复医学 康复医学
背景情况:
- 老年人经常经历重复住院和熟练的护理机构停留接近生命的终点,称为"重生至死".
- 严重疾病沟通 (SIC) 旨在使患者的目标与护理保持一致,但其在严重疾病的护理过渡中的应用缺乏研究.
- 在复杂的过渡期间,有效的沟通对于符合目标的护理至关重要.
研究的目的:
- 为医院康复临床医生开发和试点一个跨专业的SIC培训课程.
- 为临床医生提供有关严重疾病轨迹的知识和护理过渡的沟通技巧.
- 解决在护理过渡期间严重疾病的老年人SIC策略的差距.
主要方法:
- 开发了一个以证据为基础的,跨专业的SIC培训课程,题为"重生至死亡:为严重疾病患者优化护理过渡的实用策略".
- 这三期课程的目标是物理治疗师,职业治疗师和语音语言病理学家.
- 一项试点研究涉及9名康复临床医生,评估了可行性,出席率和满意度.
主要成果:
- 课程展示了高的出席率 (100%的会议1和2,89%的会议3).
- 参与者报告说,他们对严重疾病知识和关于预后信息和护理过渡建议的沟通的自我评价信心增加了.
- 相当多数 (78%) 的人会推该课程,认为它与临床实践相关.
结论:
- 为医院康复临床医生实施SIC课程是可行的.
- 培训提高了临床医生的信心和沟通严重疾病和护理过渡的技能.
- 这种方法对优化护理过渡和改善严重疾病的老年人目标一致的护理充满希望.
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