揭开临床医生共同决策的采用:通过传播创新理论的透镜进行定性探索
Laura Spinnewijn1,2, Johanna Wm Aarts3, Didi Braat4
1Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands lauraspinnewijn@gmail.com.
BMJ open
|June 22, 2024
概括
共享决策 (SDM) 的采用面临临临床医生的挑战,包括时间限制和偏好冲突. 通过传播创新理论来理解这些动态,可以改善以患者为中心的护理.
科学领域:
- 提供医疗保健服务.
- 医疗实践的创新医疗实践的创新
- 患者的参与度 患者的参与度
背景情况:
- 共享决策 (SDM) 对于以患者为中心的护理至关重要.
- 了解临床医生采用障碍是成功实施的关键.
- 创新传播 (DOI) 理论为分析采用动态提供了一个框架.
研究的目的:
- 探索在临床实践中采用共享决策 (SDM) 的方法,使用创新扩散 (DOI) 理论.
- 确定影响临床医生采用SDM的挑战和促进者.
- 为改善医疗保健中以患者为中心的决策提供见解.
主要方法:
- 使用修改框架分析方法进行定性研究.
- 从先前的研究中整合人种学和采访数据.
- 另外还对20名妇产科的临床医生进行了采访.
主要成果:
- 临床医生认为SDM对患者的自主性和医疗实践有价值,决策辅助器的帮助.
- 挑战包括偏好不匹配,时间限制和医疗保健的快速步伐.
- 感知到的复杂性,有限的可试验性和同事的态度影响了采用.
结论:
- 临床医生采用SDM受到信仰,认知过程和上下文因素的影响.
- 认知失调在临床医生将SDM与现有实践相协调时发挥着作用.
- 实践评估和反思实践等策略可以支持明智的采用决策.
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