在外科手术中的决策
Peter Angelos1, Lauren J Taylor2, Kevin Roggin3
1Department of Surgery, The University of Chicago, Chicago, Illinois; MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois.
The Annals of thoracic surgery
|January 19, 2024
概括
对于高风险的心胸手术,外科医生需要更好的沟通技巧. 改善手术前后的共享决策和患者参与,对于符合目标的护理至关重要.
科学领域:
- 医学伦理 医学伦理
- 手术沟通手术沟通
- 以患者为中心的护理
背景情况:
- 心胸外科手术涉及高风险,快速的决策,通常与有限的先前患者关系.
- 有效的沟通对于知情同意和处理复杂的术后情景至关重要.
研究的目的:
- 审查心胸外科手术中术前和术后决策和沟通方面的挑战.
- 探索共享决策作为知情同意的首选方法.
- 为优化外科医生沟通和患者/家庭参与提供战略.
主要方法:
- 对知情同意的伦理和法律要求的文献综述.
- 对患有严重疾病的老年患者的高风险手术中决策挑战的分析.
- 探索诸如临床英雄主义和手术结果的无用性等概念的沟通.
主要成果:
- 共享决策是知情同意的当代标准.
- 手术后的决策往往涉及代理决策者,当患者失去能力时.
- 需要有效的沟通策略来解决患者的不满,并确保符合目标的护理.
结论:
- 外科医生必须提高沟通技巧,以提高患者和家庭的参与度.
- 解决术后决策中的伦理挑战对于最佳的患者护理至关重要.
- 沟通框架可以支持高风险的外科手术场景,特别是对弱势群体.
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