临床推理在急性护理的功能障碍评估和管理期间:一项纵向定性研究
Sulekha Gunasekaran1, Joanne Murray1,2, Sebastian Doeltgen1,2
1Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
International journal of language & communication disorders
|January 22, 2024
概括
语音语言治疗师 (SLT) 使用不断发展的临床推理,整合新的信息,在急性护理期间完善失调管理. 这种以患者为中心的方法通过反复评估和更新建议来确保高效,高质量的护理.
科学领域:
- 临床吞检查 (CSE) 临床吞检查
- 消化不良症管理 消化不良症管理
- 语音语言病理学 (SLP)
背景情况:
- 有效的临床推理对于准确的功能障碍评估和管理至关重要.
- 之前的研究重点是初始的CSE,但患者急性护理过程中临床推理的演变仍未得到充分探索.
- 了解语音语言治疗师 (SLT) 如何整合新患者信息来修改管理是必不可少的.
研究的目的:
- 调查SLT临床推理和决策在断食症评估和管理中的演变.
- 分析这些过程如何随着患者通过急性医院护理,从转诊到出院而变化.
主要方法:
- 一项纵向的定性研究,涉及两名临床医生和急症医院的六名患者.
- 追溯的"大声思考"协议被用来捕捉SLT在初始和后续评估期间的推理.
- 概念映射 (描述性,推理,假设) 分析推理类型 (诱导性/演性),假设和建议.
主要成果:
- 最初的CSEs严重依赖于诱导推理来产生假设并确定安全的饮食/液体建议.
- 后续评估显示,增加了检验初始假设的演推理,重点关注呼吸道保护,医疗状况和饮食/液体耐受性或升级.
- 评估优先考虑管理建议而不是正式诊断,没有报告患者不良结果.
结论:
- 在急症护理中,吞管理是一种高质量的以患者为中心的过程,利用代的诱导和演推理周期.
- 这种适应性推理方法优化了效率,而不影响护理质量.
- 建议进一步研究和纳入职业教育,以完善诊断和管理流程.
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