使用对话分析来探索医院环境中的决策能力评估
Jessica Foulkes1, Anna Volkmer2, Suzanne Beeke2
1Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
International journal of language & communication disorders
|February 20, 2024
概括
对话分析 (CA) 揭示了医疗保健专业人员如何对获得性脑损伤 (ABI) 相关的沟通困难的人进行能力评估. 调查结果显示,人们遵守了"精神能力法案" (MCA) 的指导方针,并偏离了指导方针,突出了改善实践和培训的领域.
科学领域:
- 临床心理学 临床心理学
- 医疗保健通讯 医疗保健通讯
- 神经康复疗法 神经康复疗法
背景情况:
- 医疗保健专业人员 (HCP) 必须根据"精神能力法" (MCA) 进行决策能力评估.
- 现有的指南缺乏关于评估行为的实际细节,医疗保健人员面临的挑战是评估沟通困难的个人的能力.
- 需要观察性研究来了解现实世界能力评估实践.
研究的目的:
- 客观地分析,使用对话分析 (CA),对经历获得性脑损伤 (ABI) 相关沟通困难的患者进行现实生活能力评估.
- 确定使用CA的可行性,以增强有关能力评估过程的知识.
主要方法:
- 服务评估包括四个自然产生的能力评估的视频记录.
- 参与者包括语音和语言治疗师,职业治疗师,神经心理学家以及与ABI相关的沟通困难患者.
- 谈话分析 (CA) 方法被应用来调查交互行为,由MCA最佳实践指南提供信息.
主要成果:
- 一项能力评估显示了六个阶段的结构 (开放,准备,选项上市,测试,决定,关闭),与MCA最佳实践保持一致.
- 准备阶段包括收集和提供信息.
- 在各个评估中观察到与这种结构的差异,特别是在提出选项的方式上.
结论:
- 对话分析 (CA) 是一种可行的方法,用于经验地探索能力评估的结构和行为.
- CA可以识别和描述与MCA最佳实践指导一致或分离的交互行为.
- 未来与不同专业和患者群体的CA研究可以为进行能力评估的医疗人员提供基于证据的培训.
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