提供者对手术患者心肺复苏的看法 虚弱的手术患者
Matthew B Allen1, Amanda J Reich2, Patrick Collins1
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Annals of surgery
|January 23, 2024
概括
提供者对心肺复苏 (CPR) 在脆弱的手术患者的看法因专业而异. 了解脆弱和潜在偏见的差异,如年龄歧视,可能会阻碍对这些患者的目标一致的护理.
科学领域:
- 老年医学 老年医学
- 手术护理 手术护理
- 麻醉学 麻醉学
- 生物伦理学生物伦理学
背景情况:
- 接受手术的老年人群增加了脆弱的患病率.
- 越来越多地强调符合目标的护理和脆弱性评估.
- 在脆弱的患者中,提供者对外科手术期间心肺复苏 (CPR) 的看法仍然基本上没有特征.
研究的目的:
- 调查和描述外科医生,麻醉科医生和老年病医生对外科手术期间心肺复苏在脆弱的手术患者的看法.
- 了解不同的医学专业如何看待心肺复苏在这个脆弱的患者群体中的适当性和应用.
主要方法:
- 对8名麻醉科医生,10名外科医生和9名老年医生的半结构面试进行了定性主题分析.
- 在两个学术医疗中心进行的采访,重点是了解脆弱性,心肺复苏决策和脆弱患者对外科术后心肺复苏的看法.
主要成果:
- 在脆弱的患者中,对术后心肺复苏的看法在提供者专业之间有很大差异.
- 关于CPR适当性的决定是多因素的,考虑患者的目标,年龄,并发病症和逮捕原因.
- 道德上的痛苦与脆弱患者的复苏工作有关.
- 偏见,包括能力主义和年龄主义,可以影响对CPR适当性的看法.
- 没有充分的证据证明在经过外科手术期间心肺复苏的脆弱患者中存在风险分层.
结论:
- 麻醉师,外科医生和老年医生如何感知虚弱对心肺复苏决策的影响存在差异.
- 不同的观点可能会阻碍符合目标的护理服务.
- 需要进一步的研究来告知风险分层,预测结果,并解决潜在的偏见,如年龄歧视和能力主义.
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