在乌干达农村卫生机构的医疗保健共享决策过程中的经验和伦理问题:一项探索性定性研究
Ranga Solomon Owino1, Nelson K Sewankambo2, Olivia Kituuka2
1Makerere University Lung Institute, Kampala, Uganda.
Research square
|October 7, 2024
概括
患者希望参与医疗保健决策,但乌干达的农村环境对共享决策提出了挑战. 培训医疗保健提供者和患者对于道德参与和改善健康结果至关重要.
科学领域:
- 公共卫生 公共卫生
- 医疗保健管理的管理
- 医学伦理 医学伦理
背景情况:
- 共享决策 (SDM) 对于以患者为中心的护理至关重要,赋予个人健康选择的权力.
- 有效的SDM需要患者参与,但农村环境经常面临参与的障碍.
- 这项研究调查了乌干达东部农村地区患者和提供者对SDM的经验.
研究的目的:
- 探索患者和医疗保健提供者在乌干达农村卫生中心的共同决策的经验.
- 在这种环境中,识别在SDM过程中遇到的挑战和伦理问题.
- 提出增强SDM和伦理患者参与的策略.
主要方法:
- 采用了一种探索性定性研究设计.
- 对12名医疗保健提供者和11名患者进行了23次深入采访.
- 使用NVivo-12加软件进行的主题分析,促进了数据解释.
主要成果:
- 患者表达了强烈的愿望参与他们的医疗保健决策.
- 对SDM的重大挑战包括男性参与度低以及文化/父权影响.
- 确定了诸如知情同意,隐私和潜在危害等道德问题.
结论:
- 需要有针对性的干预措施,包括SDM手册和提供者培训,以改善患者的伦理参与.
- 建议提高患者的敏感性,并为医疗保健提供者提供全面的培训.
- 需要在更大的设施和不同患者群体进行进一步的研究.
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