揭开低价值护理决策:居民对环境因素影响的观点
Lotte A Bock1,2, Cindy Y G Noben1, Roel H L Haeren3
1Academy of Postgraduate Medical Education, Maastricht University Medical Centre, Maastricht, The Netherlands.
International journal of health policy and management
|August 5, 2024
概括
了解低价值护理需要探索影响居民决策的上下文因素. 住户最受患者和主管互动的影响,组织和环境因素塑造了他们的选择.
科学领域:
- 医学教育 医学教育
- 医疗保健管理的管理
- 临床决策 - 临床决策
背景情况:
- 低价值的护理,或医疗保健中的浪费,是一个重大挑战.
- 减少低价值护理的现有举措取得了不同程度的成功.
- 对环境对低价值护理决策的影响还不太清楚.
研究的目的:
- 探索影响居民关于低价值护理的决策的背景因素.
- 识别特定的环境,组织和人际关系影响.
- 为减少医疗培训中低价值护理的策略提供信息.
主要方法:
- 使用名义组技术 (NGT) 选择小幅的定性研究.
- 与居民进行的个人采访,以小幅的视频为依据.
- 在Bronfenbrenner的社会生态框架的指导下,对采访数据进行主题分析.
主要成果:
- 确定了33个影响居民对低价值护理决定的上下文因素.
- 这些因素涵盖环境,社会政治,组织,人际关系和个人层面.
- 关键的影响包括患者互动,监督者关系和组织/环境约束.
结论:
- 居民对低价值护理的决策是由上下文因素的复杂相互作用所塑造的.
- 个人间的动态 (患者和监督者的互动) 尤其具有影响力.
- 有针对性的干预措施,特别是提高居民的沟通技巧,可以帮助减少低价值的护理.
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