在ICU中共享决策沟通和预测误解
Judith B Vick1,2,3, Benjamin T Berger1, Peter A Ubel1,4
1Department of Medicine, Duke University, Durham, North Carolina.
JAMA network open
|October 15, 2024
概括
共享决策 (SDM) 沟通并没有减少ICU家庭的整体预后误解. 然而,与SDM一致的沟通确实改善了具有重大预先存在的预后误解的代孕产妇的理解.
科学领域:
- 关键护理医学 关键护理医学
- 医学沟通 医学沟通
- 健康 结果 研究 研究 结果
背景情况:
- 代孕对重症监护室 (ICU) 患者生存预后的误解与患者和代孕产妇的不良结果有关.
- 共享决策 (SDM) 沟通策略可以减轻预后误解.
研究的目的:
- 调查ICU家庭会议期间SDM一致的沟通与代孕妇和医生之间的预后误解之间的联系.
- 为了确定SDM调整的沟通是否会影响生存预后感知的准确性.
主要方法:
- 一项回顾性队列研究,涉及137名代孕妇和13个重症监护室的100名医生.
- 符合SDM的沟通被定义为家庭会议期间高质量的严重疾病沟通行为.
- 预后误解被衡量为医生和代孕产妇生存预后估计之间的差异.
主要成果:
- 总的来说,SDM调整的沟通与代孕母亲或医生预后误解的减少没有显著的关联.
- 会议后观察到代孕预后误解的显著下降,但不是医生.
- 在一个小组分析中,SDM调整的沟通与具有显著基线误解的代孕产妇之间的预后误解减少有关.
结论:
- 与SDM一致的通信并没有普遍减少ICU环境中的预后误解.
- 针对SDM原则的有针对性的应用可能对具有大量预先存在的预后不确定性的代孕产妇有益.
- 需要进行进一步的研究,以优化沟通策略,以改善临床重症监护中的预后理解.
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