关于血液检测的医生-患者沟通:一般实践中的定性采访研究
Annals of family medicine
|January 25, 2024
概括
在例行血液检查中,共享决策在很大程度上缺席,患者往往不知道测试的合理性. 在诊断测试中,改善沟通对于知情同意和以患者为中心的护理至关重要.
科学领域:
- 主要护理医学 医疗保健
- 卫生沟通健康沟通
- 患者的决策制定 患者的决策
背景情况:
- 倡导共享决策 (SDM),但主要研究治疗决策,诊断测试的证据有限.
- 尽管实验室检测率不断上升,但对SDM在初级保健中进行常规血液检测的研究很少.
- 诊断中SDM的现有证据集中在PSA,查和遗传测试等特定测试上.
研究的目的:
- 探索在英国初级保健中围绕常规血液检测的共享决策 (SDM) 和沟通动态.
- 调查患者和全科医生 (GP) 对订购和接收血液检测结果的过程的观点.
- 在常规诊断测试的背景下,识别有效沟通和SDM的障碍和促进者.
主要方法:
- 在英国初级保健中进行的定性采访研究.
- 与28名患者 (在/检测后不久和收到结果后) 和19名全科医生进行了对面采访.
- 对80次录制和转录的采访进行主题分析,使用归纳/归纳编码和常数比较.
主要成果:
- 没有发现共享决策的情况;患者经常缺乏对所进行的测试及其目的的认识.
- 障碍包括信息复杂性,缺乏分享资源,以及讨论血液测试的优先级较低.
- 一般医生有时采用一种父权主义的方法,证明测试是为了防止患者的焦虑,导致患者的误解和丧.
结论:
- 诊断测试,特别是常规血液检查的共同决策与治疗决策有很大的不同.
- 这些发现突出了在常规诊断测试中知情同意和患者理解的基本问题.
- 促进共享理解和SDM可以优化测试,减少不必要的调查,并加强以患者为中心的护理.
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