将以患者为中心的沟通扩展到不说话的智力残疾人
Ally Peabody Smith1, Ashley Feinsinger2
1Department of Medicine, David Geffen School of Medicine, Los Angeles, California, USA.
Journal of medical ethics
|February 19, 2024
概括
以患者为中心的沟通应该包括智力障碍的非说话人士. 关于残疾的假设阻碍了沟通;调整方法可以改善对这些患者的护理和尊重.
科学领域:
- 医学沟通 医学沟通
- 智力障碍研究 智力障碍研究
- 医疗保健道德 医疗保健道德
背景情况:
- 以患者为中心的沟通是现代医疗保健的基石,旨在改善结果并尊重患者的自主权.
- 当患者有不同的沟通需求,特别是智力障碍患者时,有效的沟通受到挑战.
- 围绕智力障碍的假设可能会对医疗保健提供者的沟通策略和患者参与产生负面影响.
研究的目的:
- 探索关于智力障碍的假设如何影响与非说话患者的沟通.
- 倡导将以患者为中心的沟通原则扩展到非语言智力障碍的个人身上.
- 建议可行的策略,以提高这种患者群体的沟通和决策.
主要方法:
- 与智力障碍和沟通有关的假设的概念分析.
- 对非说话个体的多样化沟通实践的证据的审查.
- 根据伦理原则和沟通理论制定建议.
主要成果:
- 关于智力障碍的负面假设可能导致沟通减少和被排除在决策之外.
- 智力障碍的非说话个体具有各种各样的沟通能力,但这些能力往往被低估.
- 当前的做法可能错误地将沟通能力等同于决策能力.
结论:
- 医疗保健提供者应该将智力障碍的非语言人士视为有能力的沟通者.
- 策略包括延长预约时间,将能力与沟通分开,并促进支持决策.
- 承认支持决策和以患者为中心的沟通之间的联系对于公平的护理至关重要.
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