危急病患者及其医生的共同决策过程中确定的价值观,偏好和目标
Sharyn L Milnes1,2,3, Yianni Mantzaridis1, Nicholas B Simpson1,3
1University Hospital Geelong, Barwon Health, Geelong, Australia.
概括
医生们在讨论关键的护理目标时确定了患者的关键价值观,偏好和目标. 关键主题包括人际关系,自主,生活质量和身体舒适.
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.
- 密集护理医学 密集护理医学
背景情况:
- 关怀目标 (GOC) 讨论对于临终性疾病的重症患者至关重要.
- 了解患者的价值观,偏好和目标对于有效的共同决策至关重要.
- 该iValidate计划旨在提高重症监护室 (ICU) 注册人员的共享决策技能.
研究的目的:
- 检查在中国政府讨论期间从危急病患者中获得的价值观,偏好和目标.
- 确定这些讨论中出现的关键主题,以告知临床实践.
- 评估共享决策计划对获取以患者为中心的信息的影响.
主要方法:
- 使用四阶段潜伏内容分析进行了一项描述性定性研究.
- 分析了来自218名成人患者的354份中华人民共和国政府表格,这些成年患者因患有生命限制疾病而入院到三级重症监护室.
- 数据被分类为主题和子主题,代表患者的价值观,偏好和目标.
主要成果:
- 四个主要主题出现了:连接和关系自主,决策者的自主,平衡生活质量和数量,以及身体舒适.
- 这些子主题包括人际关系,感觉,享受活动,独立,尊严,认知功能,生活质量,寿命和身体舒适.
- 与人际关系,地点,独立性和身体舒适性相关的陈述最常见;寿命最少.
结论:
- 对中国政府讨论的分析揭示了患者价值观,偏好和目标的框架.
- 这一框架可以帮助临床医生与重症患者参与共享决策.
- 共享决策培训和支持计划对于在ICU环境中的终身护理有效沟通至关重要.
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