在COVID-19期间导航"良好的死亡":通过临床笔记了解实时终身护理结构,过程和结果
Emily Franzosa1,2, Patricia S Kim1, Laura T Moreines3
1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
The Gerontologist
|August 27, 2024
概括
随着COVID-19的流行,临床医生和家庭的决定受到严重影响. 调整改善了护理,但压迫了护理人员,突出了需要更好的支持和沟通的需求.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 公共卫生 公共卫生
背景情况:
- 随着COVID-19的流行,临终关怀的提供受到重大干扰.
- 关于大流行对临床医生和家庭在终身护理中的决策影响的研究有限.
研究的目的:
- 调查COVID-19大流行如何影响生命终端护理的结构,过程和结果.
- 了解疫情期间临床医生和家庭之间的决策动态.
主要方法:
- 来自纽约市老年医疗实践的61名临终关怀病人的回顾性图表审查 (2020年3月至2021年3月).
- 使用定向内容分析分析纵向,非结构化的电子健康记录笔记的分析.
主要成果:
- 护理过程是由人事和政策等结构因素所塑造的.
- 优先考虑的结果包括患者安全,高触摸护理和情感/精神支持.
- 参与即时决策,护理和支持的关键过程.
结论:
- 终身护理过程需要临床医生和家人的持续谈判和即时决策.
- 流行病适应措施虽然有效,但增加了护理人员的负担.
- 建议包括加强护理人员支持,改善团队间沟通,扩大社会/精神护理服务.
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