寻求"平衡现场":对临床医生如何在重症监护中运行社会决定因素的定性研究
Deepa Ramadurai1,2,3, Heta Patel4, Jacqueline Chan5
1Division of Pulmonary, Allergy, and Critical Care Medicine and.
Annals of the American Thoracic Society
|August 6, 2024
概括
重症监护病房的临床医生使用健康的社会决定因素 (SDOH) 来理解患者的故事,并提供个性化的护理,改善结果. 整合患者的观点是有效的SDOH评估在重症监护的关键.
科学领域:
- 关键护理医学 关键护理医学
- 公共卫生 公共卫生
- 卫生公平性健康公平性
背景情况:
- 健康的社会决定因素 (SDOH) 并没有系统地纳入重症监护.
- 在重症监护室 (ICU) 评估SDOH可能会提高临床决策,以患者为中心的结果和临床医生的福祉.
研究的目的:
- 探索ICU临床医生在重症期间如何感知和利用SDOH.
- 在ICU环境中识别SDOH评估的障碍和促进者.
主要方法:
- 与30名ICU临床医生进行半结构面试.
- 在患者护理中检查SDOH的图表刺激回忆.
- 使用CDC SDOH框架对未被识别的转录进行主题分析.
主要成果:
- 临床医生通过个人身份,患者关系和护理结构来框架SDOH使用.
- 讨论SDOH有助于识别患者偏见,疾病驱动因素和护理人员沟通挑战.
- 障碍包括时间限制,高风险情况和ICU内的情绪因素.
结论:
- 临床医生使用SDOH来理解患者的叙述,并提供个性化的护理,潜在地提高了满意度和结果.
- 未来的努力应纳入患者和护理人员对SDOH收集和ICU使用的观点.
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