提供者对无家可归患者手术护理的挑战和促进者的看法:定性分析
Hannah Decker1, Mukund Raguram2, Hemal K Kanzaria3
1Department of Surgery, University of California at San Francisco, San Francisco, CA.
Surgery
|December 23, 2023
概括
无家可归的患者面临着重大的外科护理挑战,从手术前的需求到术后的出院. 解决这些不平等问题需要系统层面的干预,以改善这种脆弱人群的外科治疗结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康上的不平等.
背景情况:
- 与普通人群相比,没有住所的患者经历的外科治疗结果较差.
- 导致手术护理差异的具体因素仍未得到充分研究.
研究的目的:
- 调查无家可归患者在整个外科护理连续过程中所面临的挑战和不平等.
- 确定临床医生对障碍的看法,以优化无家可归者的手术护理.
主要方法:
- 进行了26次半结构面试,与各种临床医生 (外科医生,医生,APP,社会工作者,护士) 进行了面试,他们有经验照顾无家可归的患者.
- 雇员有目的的抽样,以确保跨角色和环境的代表性,包括医疗休息和街头医学.
- 利用专题分析来识别临床医生经验中反复出现的模式和主题.
主要成果:
- 确定了影响外科护理的五个关键主题:手术前的挑战,在轻微决定中考虑住房状况,手术后的负面医院经历,导致护理不足的不完美出院选择以及放大通信障碍.
- 临床医生报告说,他们很难满足未住院的患者手术前的要求.
- 住房状况影响了小手术护理决策,出院计划往往导致术后护理不足最佳.
结论:
- 照顾无家可归的外科患者的临床医生在所有护理阶段都会遇到多方面的挑战.
- 临床医生采用正式和非正式的策略来应对这些挑战.
- 有机会进行有针对性的干预,以提高无家可归者获得手术护理的机会和结果.
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