了解患者:理解复杂心力衰竭复杂心力衰竭的再入院原因
The Journal of cardiovascular nursing
|November 28, 2023
概括
患者和临床医生对心力衰竭再入院的看法有很大的不同. 了解这些不同的观点,并考虑诸如心力衰竭阶段等因素,对于制定有效的护理计划以防止未来住院至关重要.
科学领域:
- 心脏病学 心脏病学
- 医疗保健管理的管理
- 患者体验 患者体验
背景情况:
- 心力衰竭 (HF) 是一个重要的健康问题,住院和30天再入院率很高.
- 现有研究表明,患者和临床医生对HF再入院原因和可预防性的观点之间存在差异,特别是当疾病严重程度未被充分考虑时.
研究的目的:
- 调查和比较患者,护理人员,护士和医生对30天HF再入院的主观原因.
- 评估利益相关者对可预防性的不同看法,考虑上下文因素.
- 评估患者和临床医生之间关于再接收原因的共识程度.
主要方法:
- 采用了融合,并行,混合方法设计,整合了采访和图表审查.
- 从30天内因心力衰竭重新入院的成年患者,他们的护理人员,主治医生和分配的护士收集了数据.
- 评估了来自指数和当前住院时间的上下文因素.
主要成果:
- 采访包括44名患者,6名护理人员,24名医生和44名护士. 大多数再接收 (95%) 是新兴/紧急的,平均在出院后14.9天发生.
- 大多数患者 (73%) 患病严重程度和死亡风险高,尽管HF阶段文档不一致.
- 在重新入院和可预防性的感知原因中观察到显著的差异,患者和临床医生的一致性很低 (30%). 患者引用症状,医生引用诊断,护士引用行为.
结论:
- 患者和临床医生对高频率再入院原因和可预防性的看法有很大差异,特别是在复杂的高频率病例中.
- 对高频段的不一致文档以及其他上下文因素导致了不同的观点.
- 量身定制的护理规划,包括HF阶段和上下文因素,对于实现共同理解和实施有效的症状管理来减少再入院至关重要.
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