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儿童耳鼻喉科决策共享的障碍和促进者:一种定性研究
Usman Khan1, Erin Luther2, Christine E Cassidy3
1Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
概括
儿科耳鼻喉科医生重视共享决策 (SDM),但面临障碍. 关键的挑战包括将SDM知识转化为实践,父母的社会影响和环境因素,如有限的预约时间.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 医疗保健服务研究 医疗服务研究
- 决策科学 决策科学 决策科学
背景情况:
- 共享决策 (SDM) 对于以患者为中心的护理至关重要.
- 在儿科耳鼻喉科中实施SDM存在独特的挑战.
- 了解障碍物和促进者对于有效的SDM集成至关重要.
研究的目的:
- 确定在儿科耳鼻喉科中实施SDM的障碍和促进者.
- 探索儿科耳鼻喉科医生对SDM的看法.
- 为改善儿科外科护理中SDM的策略提供信息.
主要方法:
- 使用儿童耳鼻喉科医生的半结构面试进行的定性研究.
- 理论领域框架 (TDF) 和COM-B模型指导数据收集和分析.
- 采访的重点是桃体切除术,腺切除术和 tympanostomy 管放置的决定.
主要成果:
- 出现了四个主要主题:不一致的SDM包容性,父母的社会影响,环境背景和SDM适用性.
- 外科医生认为SDM有价值,但往往缺乏结构化的方法和父母价值观的明确讨论.
- 障碍包括约会时间短,员工支持有限,缺乏决策辅助工具,而感知到的好处包括父母所有权和减少遗憾.
结论:
- 儿科耳鼻喉科医生认识到SDM对父母参与治疗决策的价值.
- 实施SDM的主要障碍包括SDM知识与临床实践之间的差距,社会影响和环境限制.
- 解决这些障碍对于提高儿科耳鼻喉科的SDM至关重要.
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