医生对治疗60天以下发烧婴儿的决策过程的看法:一个现象学定性研究
Ioannis Orfanos1,2, Rose-Marie Lindkvist3, Erik G A Eklund4,5
1Department of Clinical Sciences, Lund University, Lund, Sweden. ioannis.orfanos@med.lu.se.
BMC pediatrics
|January 26, 2024
概括
医生发现腰部穿刺 (LP) 在管理发烧的婴儿时具有挑战性. 临床判断和婴儿状况影响LP决策,这表明准则需要灵活性.
科学领域:
- 儿科 儿科 儿科
- 临床决策 - 临床决策
- 传染病管理 传染病管理
背景情况:
- 发烧的婴儿 (≤60天) 的管理和指导方针的遵守有所不同.
- 在这个群体中,医生决策过程需要进一步阐明.
研究的目的:
- 描述管理发烧婴儿 (≤60天) 的决策过程.
- 确定影响医生关于发烧婴儿腰部穿刺 (LP) 的决定的因素.
主要方法:
- 使用6个重点小组进行的定性研究,包括儿科急诊室的19名医生.
- 归纳式,现象学方法与第二阶段的视角.
- 使用7步方法对转录的采访进行分析.
主要成果:
- 腰部刺穿 (LP) 被认为是复杂的和情感上的征税.
- 影响LP决策的关键因素包括:疑似感染源,父母发烧报告准确性和婴儿的一般状况.
- 其次因素包括:医生对判断的信任,对失败的恐惧,工作负担,对他人的考虑,指导方针/资源平衡以及对实践的需求.
结论:
- LP的困难和情绪负担显著影响决策.
- 医生强调临床判断和独立决策的重要性.
- 准则应包含灵活性,以适应个体患者的特征和需求.
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