在跨动脉再血管化的时代,患者决策
Brianna M Krafcik1, David H Stone2, Salvatore T Scali3
1Department of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Journal of vascular surgery
|March 6, 2024
概括
动脉再血管化的共同决策 (SDM) 是一个复杂的过程. 患者的价值观,理解和自主性偏好显著影响着心脏动脉内关节切除术和心脏动脉外再血管化 (TCAR) 之间的选择.
科学领域:
- 血管外科 血管外科
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 医疗保险授权共享决策 (SDM) 进行动脉支架.
- 目前的SDM工具中没有一个包含跨动脉再血管化 (TCAR).
- 了解患者和外科医生的偏好对于有效的SDM至关重要.
研究的目的:
- 唤起患者和外科医生的经验和偏好用于动脉再血管.
- 告知 SDM 工具的开发,用于动脉干预.
- 改善动脉疾病的共享决策过程.
主要方法:
- 与20名患者进行了长度周围手术半结构面试.
- 采访了9名血管外科医生.
- 有目的的最大变化采样和诱导性内容分析.
主要成果:
- 三个关键的决策领域:患者价值观,疾病/程序理解和决策风格.
- 患者的价值包括成功率和程序员经验.
- 偏好从自主性到提供者主导的决策各不相同;外科医生是关键信息来源.
结论:
- 对于动脉再血管化的SDM是微妙的,患者的自主偏好各不相同.
- 洞察力指导有效的患者-提供者对话,用于动脉干预.
- 对于医疗保险的SDM授权来说,对于 carotid stenting来说是必不可少的.
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