从计算到沟通:使用风险评分计算器为临床决策提供信息,并促进患者参与
Hoda Fakhari1, Courtney L Scherr1, Sydney Moe1
1Department of Communication Studies, School of Communication, Northwestern University, Evanston, IL, USA.
概括
医生使用各种风险评分计算器来帮助临床判断和激励患者. 时间,患者的接受度和医生的经验等因素影响计算器的使用,强调了在实践中的细微作用.
科学领域:
- 临床信息学 临床信息学
- 医疗保健服务研究 医疗服务研究
- 医疗决策的制定 医疗决策的制定
背景情况:
- 风险评分计算器是疾病风险识别和管理的常见工具.
- 医生的经验和风险评分估计对临床决策和患者沟通的影响仍未得到充分研究.
研究的目的:
- 调查医生使用风险评分计算器的应用经验.
- 了解风险评分估计在临床决策和患者沟通中的作用.
主要方法:
- 半结构面试与20名门诊医生进行,以社区为基础的设置.
- 用基于共识的编码方法进行诱导性主题分析来分析采访数据.
主要成果:
- 医生使用了20多种风险评分计算器,其中动脉样硬化心血管疾病风险计算器是最常见的.
- 包括临床系统 (时间),患者接受度和医生经验 (例如,住院医生与临床医生) 在内的因素影响了计算器的使用.
- 风险评分估计主要支持临床判断,并作为患者的激励工具.
结论:
- 关于风险得分的医生决策和患者沟通各不相同,这表明这些工具的作用很复杂.
- 计划行为理论可以帮助解释态度,信念和规范对风险评分使用的影响.
- 需要进一步的研究,以建立利用风险评分计算器和估计的最佳实践.
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