临床医生和患者与共享决策的经验,以促进慢性中风患者的日常手臂使用:一项探索性定性研究
Amanda Gahlot1, Grace Richardson1, Patricia Librea1
1Department of Occupational Therapy, NYU Steinhardt School of Culture, Education, and Human Development, New York, NY, United States.
Frontiers in rehabilitation sciences
|October 4, 2024
概括
临床医生和中风幸存者在上肢康复中确定了共享决策 (SDM) 的促进者和障碍. 需要有针对性的教育来改善SDM在虚拟环境中的实施.
科学领域:
- 神经康复疗法 神经康复疗法
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 上肢 (UE) 损伤在中风后很常见,影响日常功能.
- 自主干预可以改善家庭使用UE.
- 共享决策 (SDM) 对于以患者为中心的护理至关重要.
研究的目的:
- 探索临床医生和患者在慢性中风UE康复中使用SDM的经验.
- 在远程,自我指导的干预中,识别SDM的促进者和障碍.
主要方法:
- 使用临床医生聚焦小组 (n=3) 和患者采访 (n=15) 的定性研究.
- 在"使用我的手臂"遥控器可行性研究中,在干预后收集的数据.
- 对面试成绩单进行主题分析.
主要成果:
- 确定的主题:平等的伙伴关系,提高临床医生的信心,这是不同的.
- 临床辅导员:SDM能力,患者特征. 患者辅导员:建立信任关系,个性化体验.
- 临床医师的障碍:SDM的专业知识,患者的参与. 患者障碍:缺乏关于中风康复的知识.
结论:
- SDM的实施需要解决临床医生和患者的培训需求.
- 推进实施科学 (CFIR) 的综合框架和CFIR-ERIC工具指导了战略开发.
- 为未来的虚拟干预建议有针对性的教育材料和会议.
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