防御性医疗保健实践:对定性证据的系统审查
Theo Lorenc1, Claire Khouja2, Melissa Harden2
1Centre for Reviews and Dissemination, University of York, York, UK theo.lorenc@york.ac.uk.
BMJ open
|July 18, 2024
概括
临床医生 临床医生
科学领域:
- 医学法律与伦理学
- 质量健康研究 质量健康研究
- 临床实践管理的管理.
背景情况:
- 防御性实践是医疗保健中的一个复杂现象.
- 了解临床医生对防御性实践的看法至关重要.
研究的目的:
- 综合临床医生的观点和防御性实践经验的定性证据.
- 探索在临床环境中防御性实践的动机和影响.
主要方法:
- 定性研究的系统审查.
- 在多个数据库中进行搜索 (MEDLINE,Embase,PsycINFO等). 从2000年开始到2023年10月.
- 从包括17项研究的数据进行了主题综合.
主要成果:
- 临床医生的防御性实践决策包括诊断,记录和治疗.
- 防御性实践往往是由一般的风险感驱动的,而不仅仅是诉讼威胁.
- 从防御性练习中感知到的伤害可以通过不信任和失去权力来放大.
结论:
- 防御性实践比理论模型更复杂,往往反映了更广泛的工作场所的担忧.
- 定性证据挑战了防御性实践作为诉讼风险和负面结果之间的主要联系的观点.
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