"困难"的住院病人,对医生观点的定性研究
Jeffrey L Jackson1,2, Mary G Murphy3, Kathlyn E Fletcher4,5
1Clement J Zablocki VAMC, Milwaukee, WI, USA. jjackson@mcw.edu.
Journal of general internal medicine
|May 20, 2024
概括
这项研究探讨了困难的医疗住院患者,发现他们在提供者中唤起负面情绪,并与具有挑战性的家庭分享特征. 有效的沟通和培训是管理这些复杂案件的关键策略.
科学领域:
- 医学教育 医学教育
- 患者护理 患者护理
- 医疗保健管理的管理
背景情况:
- 以前对困难住院患者的研究主要集中在精神病患者群体上.
- 在一般医学环境中,对于困难住院患者的特殊特征的了解有限.
研究的目的:
- 在一般医学环境中调查困难住院患者的定义特征.
- 确定这些患者的提供者经验和有效的管理策略.
主要方法:
- 使用焦点小组和半结构面试对28名医疗住院医疗服务提供者的定性研究.
- 使用MAXQDA软件对转录的采访进行主题内容分析.
主要成果:
- 困难的住院患者耗时,在提供者身上引起负面情绪 (丧,失调).
- 患者的特征包括不合作的行为,人格障碍,具有挑战性的社会情况和不切实际的期望.
- 困难家庭具有患者的共同特征,成为护理障碍,并不同意治疗计划.
结论:
- 困难的住院患者及其家人面临着共同的挑战,往往会引起医疗保健提供者的情感痛苦.
- 在困难的患者中经常观察到潜在的性格障碍.
- 增强的沟通,富有同情心的倾听和一致的信息传递是管理困难患者和家庭动态的关键策略.
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