医生如何以及为什么会传达诊断不确定性:一个实验性图片研究.
Caitríona Cox1, Thea Hatfield1, Zoë Fritz1
1The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, UK.
概括
医生以不同的方式传达诊断不确定性,隐含的表达方式比明确的表达方式更常见. 这种沟通的变化会影响患者的安全和健康不平等,需要以患者为中心的研究.
科学领域:
- 医学沟通 医学沟通
- 临床决策 - 临床决策
- 患者安全 患者安全
背景情况:
- 向患者传达诊断不确定性至关重要,但研究不足.
- 了解医生如何传达不确定性的变化对于改善患者护理至关重要.
研究的目的:
- 描述医生对诊断不确定性的沟通方式的变化.
- 探索观察到的通信变异的根本原因.
主要方法:
- 使用了四个临床图表,描绘了诊断不确定性场景.
- 对五家医院的36名医生进行了半结构化采访.
- 采用了面试成绩单的定量和定性主题分析.
主要成果:
- 在讨论差异诊断,不确定性水平和安全网方面观察到显著的差异.
- 隐含的不确定性传播比明确的更为普遍.
- 医生引用了不同的沟通目标 (例如,减少焦虑,建立信任) 和策略,并承认需要培训.
结论:
- 诊断不确定性沟通的变化持续存在,受到不同的目标和伦理原则的影响.
- 这些沟通差异对患者安全和健康公平有影响.
- 建议进一步以患者为中心的研究,以告知临床实践.
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