预先护理计划在老年病房急性入院患者的日常护理中的实施:一个集群随机对照试验的协议
Maria Romøren1,2, Karin Berg Hermansen3, Trygve Johannes Lereim Sævareid4
1Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway. maria.romoren@medisin.uio.no.
BMC health services research
|February 19, 2024
概括
这项研究对脆弱的老年人实施了预先护理计划 (ACP),以改善共享决策. 结果将加强医疗服务和实施科学,以改善以患者为中心的护理.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 脆弱的老年人和他们的家人往往缺乏参与治疗决策,导致不理想的护理.
- 这可能导致过度治疗,治疗不足,并对患者和家人造成不必要的负担.
- 提高用户参与度对于增强对这一群体的医疗服务至关重要.
研究的目的:
- 改善用户参与和医疗服务,以帮助生活在家中的脆弱老年人和他们的亲属.
- 在选定的医院病房实施和评估预先护理规划 (ACP) 干预措施.
- 评估非洲和非洲国家战略的临床和实施成果.
主要方法:
- 在12个医院单位进行集群随机试验,干预期为18个月.
- 干预包括临床ACP,实施支持 (团队,培训,工具) 和战略 (领导,整个病房的方法).
- 副研究包括420名患者,亲属和临床医生评估沟通,决策和偏好一致性;还包括定性访谈和成本效益分析.
主要成果:
- 主要结果是干预和控制手臂之间忠实度变化的差异.
- 二次结果侧重于沟通质量,决策和终身护理讨论中的一致性.
- 通过定性数据和成本效益分析,探索障碍,促进因素和资源利用.
结论:
- 该项目预计将加强预先护理计划 (ACP) 的实施.
- 它将在ACP,医疗服务研究和实施科学中产生宝贵的知识.
- 预计这些科学领域的方法发展.
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