总医生在患有急性疾病的痴呆症患者中做出困难决策的经验:一种定性,半结构化的访谈研究
Samuel Lassa1, Chris Burton2, Jon M Dickson3
1Royal Primary Care, Ashgate Research Unit, Chesterfield Royal Hospital NHS, Chesterfield, UK.
BJGP open
|September 18, 2024
概括
一般医生 (GPs) 使用外交和官僚权力来管理痴呆患者的急性疾病. 他们导航涉及患者,家庭和其他医疗保健提供者的复杂决策,展示了显著的影响力.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 定性研究是指质量研究.
背景情况:
- 一般医生 (GPs) 面临着管理痴呆患者急性疾病的复杂决策.
- 这些决定往往涉及来自多个信息者的投入.
研究的目的:
- 探索一般医生如何做出有关痴呆症患者急性疾病的决定.
- 利用微观政治方法来理解GP的决策过程.
主要方法:
- 在英国南约克郡对13名全科医生进行了定性,半结构化的采访.
- 采用微观政治镜头进行分析,重点关注痴呆症护理中的参与者决策.
主要成果:
- 一般医生充当街头官僚,在不确定性和工作压力下行使自由裁量权.
- 一般医生使用"软实力"技能,如谈判和说服,以导航复杂的决策.
- 建立关系和伙伴关系是一般医生管理护理的关键策略.
结论:
- 一般医生在痴呆症护理决策中具有正式 (官僚) 和非正式 (软实力/外交) 的影响力.
- 医生决策有效地整合了生物医学,社会和心理因素.
- 该研究强调了全科医生使用的权力动态和谈判策略.
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