临床医生在ICU家庭会议中使用选择框架
Joanna L Hart1,2,3, Leena Malik1, Carrie Li4
1Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA.
Critical care medicine
|June 24, 2024
概括
临床医生经常在与代理决策者讨论关键护理选择时使用默认框架和是/否问题. 了解这些沟通模式是改善重症监护病房 (ICU) 共享决策的关键.
科学领域:
- 医学沟通 医学沟通
- 决策科学 决策科学 决策科学
- 关键护理医学 关键护理医学
背景情况:
- 在重症监护室 (ICU) 中,有效的沟通至关重要,尤其是在与代理决策者讨论偏好敏感护理时.
- 了解临床医生如何制定选择,可以显著影响代理决策过程.
研究的目的:
- 量化临床医生在与ICU的代理决策者讨论偏好敏感护理时使用选择框架的频率和模式.
- 确定在重症监护决策环境中使用的共同选择框架.
主要方法:
- 代理孕妇与临床医生之间的101次录音会议的二次序列内容分析.
- 涉及四名编码员,从转录的会议中识别了202个偏好敏感的决策事件.
- 选择框架是根据决策科学文献先验选择的.
主要成果:
- 默认框架是临床医生使用的最常见的选择框架 (62.9%的决策事件).
- 在21.3%的决策情节中,使用了极点询问 (是/否问题).
- 临床医生倾向于提出突出潜在损失和收益的选择.
结论:
- 临床医生经常在与代理决策者讨论偏好敏感选择时使用默认框架和极性问题.
- 这些框架技术可以充当强大的推动力,影响决策结果.
- 未来的干预措施应促进这些共同选择框架在临床实践中的知情使用.
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