科提供者参与与老年人进行全面的共享决策讨论:跨部门调查结果
1College of Nursing, University of Central Florida, Orlando, FL, USA.
The American journal of hospice & palliative care
|August 22, 2024
概括
脏病提供者很少在透析前与老年人讨论保守的治疗选择. 干预措施应针对社会规范和感知控制,以改善末期病患者的共享决策 (SDM).
科学领域:
- 老年学是一门学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 行为科学 行为科学
背景情况:
- 老年人 (75岁以上) 是因末期病开始透析的最大群体.
- 与老年人进行透析前共享决策 (SDM) 讨论是不常见的,并且往往忽略了保守的管理选择.
- 改善SDM对于最终阶段病护理的知情选择至关重要.
研究的目的:
- 评估和比较由科提供者与老年人进行全面的透析前SDM讨论的行为决定因素.
- 确定旨在增强SDM意图和行为的干预措施的关键行为目标.
主要方法:
- 一个采用计划行为理论框架的横截面调查.
- 参与者包括病学家和病学先进从业者 (NP,PA).
- 调查进行在线或面对面.
主要成果:
- 态度,社会规范和感知到的行为控制与SDM行为相关.
- 在科医生和先进从业者之间观察到决定因素和行为方面的显著差异.
- 先进实践者的SDM行为主要受到社会规范和感知行为控制的影响.
结论:
- 对脏病学先进从业者的行为干预应该针对社会规范和感知到的行为控制.
- 所有已识别的决定因素可以为科医生提供干预信息.
- 需要提供商的合作,以开发有效的,集成的SDM方法进入临床工作流程.
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