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在同处和分布的农村急救队中,探索患者参与模拟紧急情况的差异 - - 一项随机交叉设计的观察性研究
Hanna Dubois1,2, Tanja Manser3,4, Henrike Häbel5
1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, K32 Karolinska University Hospital, Stockholm, S-14186, Sweden. hanna.dubois@ki.se.
BMC emergency medicine
|July 15, 2024
概括
瑞典农村地区的分布式应急团队显示,与同处的团队相比,患者参与和权力共享减少. 这凸显了远程医疗对以患者为中心的护理的潜在风险.
科学领域:
- 提供医疗保健服务.
- 在紧急医疗中进行团队合作.
- 远程医疗远程医疗
背景情况:
- 远程医疗改善了瑞典农村地区的医疗保健服务,利用视频会议系统为分布式应急团队提供医疗服务.
- 患者参与至关重要,但其在分布式团队工作中的影响仍未得到充分研究.
- 这项研究调查了同位和分布式急救队之间的患者参与和共享决策的差异.
研究的目的:
- 为了比较病人的参与行为,共定位和分布式的应急团队.
- 评估临床医生对双方团队环境中共享决策的看法.
- 鉴定因团队分布而导致的以患者为中心的护理中的潜在差异.
主要方法:
- 一项随机交叉设计的观察性研究,涉及17个团队中的51名医疗保健专业人员.
- 两个模拟的紧急情况 (共定位 vs 分布) 与标准化的患者.
- 使用PIC-ET患者参与工具评估团队的表现;通过Dyadic OPTION问卷测量共享决策.
主要成果:
- 在分布式团队 (44.7%) 与同位团队 (51.1%) 相比,观察员评级的患者参与率明显较低,p=0.02.
- 在PIC-ET工具的"共享权力"类别中,分布式团队 (2%) 与同处的团队 (14.4%) 显著下降,p=0.001.
- 自我评估的共享决策在分布式团队中 (55.8%) 低于同处的团队 (60.5%),p=0.03.
结论:
- 分布式应急团队显示患者参与度降低,特别是与患者共享权力.
- 临床医生的自我评估证实了分布式团队环境中共享决策的减少.
- 研究结果表明,患者和分布式应急团队之间的权力不对称性风险增加,需要进一步的研究和质量改进举措.
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