对外科医生手术前决策的行为干预:一个范围审查和批判性分析
Alexis G Antunez1, Katherine A Rowe2, Paul A Bain3
1Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
The Journal of surgical research
|December 12, 2023
概括
本综述探讨了通过影响外科医生的决策来减少低价值外科护理的策略. 大多数干预都集中在弥补知识差距和改善沟通,以消除不必要的程序.
科学领域:
- 实施科学 实施科学
- 外科手术取消实施
- 医学上的行为经济学.
背景情况:
- 减少低价值手术护理和影响外科医生行为的最佳策略尚未得到充分确立.
- 了解针对外科医生手术前决策的干预措施,对于开发有效的行为改变策略至关重要.
研究的目的:
- 综合描述关于行为干预的文献,旨在改变外科医生的手术前决策.
- 将这些干预措施映射到针对慢性疾病的定制实施框架中,以了解所解决的决定因素.
主要方法:
- 对四个主要数据库 (MEDLINE,Embase,Web of Science,CINAHL) 进行了范围审查.
- 包括的研究测试了外科医生的手术前决策行为干预措施.
- 使用"针对慢性疾病量身定制的实施"框架分析数据,将执行策略映射到决定因素.
主要成果:
- 从1460个初始记录中,包括了17篇全文文章.
- 干预措施包括多学科的手术前会议 (8项研究),多方面的方法 (5项研究) 和临床决策支持工具 (4项研究).
- 大多数战略旨在弥补知识差距,加强提供商沟通,并表明机构对变革的承诺.
结论:
- 术前外科手术的领域正在出现,各种方法在不同情况下可能有效.
- 未来的研究应该专注于有意识的结果测量和改进的对照组选择,以便进行可靠的比较.
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