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提供者在照顾气管切除术和呼吸机依赖儿童时的道德困扰:一个单一机构的横截面评估
Andrew J Redmann1,2, Catherine K Hart3,4, Matthew M Smith3,4
1Children's Minnesota, Pediatric ENT and Facial Plastic Surgery, Minneapolis, Minnesota, USA.
Pediatric pulmonology
|January 2, 2024
概括
在儿童病房中,对于需要气管切除/呼吸机支持的患者,道德困扰很高. 高级实践提供者报告了最高的痛苦水平,与儿科重症监护室相比较.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 医学伦理 医学伦理
- 呼吸系统护理 呼吸系统护理
背景情况:
- 照顾气管切除术/呼吸机依赖症患者的儿科单位面临着独特的伦理挑战.
- 在这些专业单位的医疗保健专业人员中,道德困扰是他们关心的一个重要问题.
- 了解道德困境的普遍性和来源对于支持员工福祉至关重要.
研究的目的:
- 量化医疗保健专业人员在儿童病房中经历的道德困扰水平,用于气管切除术/呼吸机依赖患者.
- 在单位内的不同专业群体中比较道德困境水平.
- 建立旨在减轻道德痛苦的干预措施的基准.
主要方法:
- 这项研究使用了道德困扰调查修订 (MDS-R),这是一个21个问题的工具.
- 该调查是匿名分发给医生 (MD/DO),高级实践从业者 (APP),注册护士 (RN) 和呼吸治疗师 (RT).
- 进行描述性统计,双变量和多变量分析来解释数据.
主要成果:
- 从127个分布式调查中获得了48%的响应率.
- 平均MDS-R得分为83,表明与儿科重症监护病房相当的重大道德困扰.
- 高级实践从业者报告了最高的中位数道德困扰得分 (112),而医生报告了最低的 (49).
结论:
- 在长期的气管切除术/呼吸机依赖患者的儿科病房中,道德困扰是普遍且显著的.
- 高级实践从业者经历了更高水平的道德困境,可能是由于他们对复杂案件的主要提供者角色.
- 这些发现强调了在这些苛刻的临床环境中为医疗保健专业人员提供有针对性的支持和干预措施的需要.
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