关于危急疾病的共同决策的种族差异
Deepshikha C Ashana1,2,3, Whitney Welsh4, Doreet Preiss4
1Department of Medicine, Duke University, Durham, North Carolina.
JAMA internal medicine
|February 26, 2024
概括
与白人护理人员相比,重症监护医生提供了较少的情感支持,并与黑人护理人员分享了较少的信息. 这凸显了重症患者共同决策的差异.
科学领域:
- 医学沟通 医学沟通
- 健康差异 在健康上的差异
- 关键护理医学 关键护理医学
背景情况:
- 共享决策 (SDM) 对于在重症监护中导航复杂的治疗选择至关重要.
- 不同患者和护理人员群体之间公平的SDM尚未得到充分理解.
研究的目的:
- 为了比较重症监护临床医生的SDM沟通模式与黑白护理人员.
- 在危急疾病期间识别临床医生与护理人员互动的种族差异.
主要方法:
- 从一项关于机械通风决策辅助器的试验中录制的临床医生护理人员会议的主题分析.
- 分析包括13个美国重症监护病房的39次会议.
- 一本代码书专注于SDM组件和种族沟通差异;分析师对护理人员的种族视而不见.
主要成果:
- 基于护理人员的种族,临床医生的行为出现了四个关键差异.
- 临床医生提供了较少的情感支持,并承认黑人护理人员的信任/感激程度较低.
- 有限的医疗信息被共享,黑人护理人员对恢复性护理的偏好经常受到质疑.
结论:
- 关键护理临床医生错过了与白人护理人员相比验证黑人护理人员的情绪和知识的机会.
- 研究结果表明,临床医生层面的干预措施有可能改善公平的SDM.
- 解决这些差异对于以患者为中心的重症监护至关重要.
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