在现实世界初级保健机构中,如何传达和管理诊断不确定性?
Jessica Russell1, Laura Boswell2, Athena Ip2
1Wolfson Institute of Population Health, Queen Mary University of London, London, UK. Jessica.russell@gosh.nhs.uk.
BMC primary care
|August 12, 2024
概括
英国的全科医生使用诸如症状监测和治疗等策略来管理诊断的不确定性. 向患者传达管理计划往往涉及直接交付,而不是谈判.
科学领域:
- 初级医疗保健医学 一级医疗保健医学
- 诊断不确定性管理的管理
- 定性研究方法 定性研究方法
背景情况:
- 诊断不确定性是初级保健中的一个重大挑战,影响了患者的信任,并可能导致错误.
- 有效的管理对于预防诊断错误,治疗延迟和低于最佳结果至关重要.
研究的目的:
- 探索英国全科医生如何在初级保健咨询中管理和沟通诊断不确定性.
- 了解一般医生在没有立即确定的诊断的情况下采用的策略.
主要方法:
- 使用GP-患者咨询的视频和音频录制的定性研究.
- 使用修改后的,经过验证的工具对字面转录进行分析,以捕捉GP的行动和沟通,包括"安全网"建议.
- 视频数据分析,评估管理计划交付期间的非语言沟通 (身体姿势).
主要成果:
- 在行政任务中,全科医生采用了诸如症状监测 (有或没有治疗) 和风险管理等策略.
- 对诊断不确定性的管理计划的具体性各不相同,很少有全科医生详细说明行动和时间表.
- 管理计划的责任通常通过直接交付转移到患者身上,患者通常在讨论结束之前接受.
结论:
- 为医疗保健专业人员提供指导,以提高对诊断不确定性管理计划的认识和沟通.
- 改进的沟通策略可以帮助保持患者的信任,并尽量减少初级保健机构的诊断错误.
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