提供者对儿科心脏重症监护病房结果的看法
Preston J Boyer1,2, Kurt R Schumacher3, Kate Thornsberry3
1University of Michigan C.S. Mott Children's Hospital Congenital Heart Center, Ann Arbor, MI, USA. pboyer6@jh.edu.
Pediatric cardiology
|November 26, 2024
概括
儿科心脏重症监护室提供者接受身体外膜氧化 (ECMO) 或心肺复苏 (CPR) 的死亡风险为50%,但担心长期并发症. 他们还低估了患者的生活质量.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 密集护理医学 密集护理医学
- 医学伦理 医学伦理
背景情况:
- 提供者的看法显著影响了有关儿科外体膜氧化 (ECMO) 和心肺复苏 (CPR) 的决策.
- 对于儿童心脏重症监护病房 (PCICU) 中提供者角色和经验如何塑造这些感知,人们的理解有限.
研究的目的:
- 探索和比较多学科PCICU提供者对ECMO和CPR的风险耐受性和与健康相关的生活质量 (HRQoL) 的看法.
- 调查提供者角色和经验对这些感知的影响.
主要方法:
- 对101名多学科PCICU提供者进行了一项调查,评估两种患者场景的并发症风险耐受性和对HRQoL的感知影响:心脏病停顿后ECMO心脏手术和心脏病停顿后CPR.
- 根据提供者的角色 (例如,护士,医生) 和经验水平,分析了回复.
主要成果:
- 与其他与ECMO或CPR相关的长期发病率相比,提供者对50%的死亡风险的耐受性更高.
- 护士对并发症的风险耐受性低于主治医生,提供者的经验没有显著影响.
- 所有接受调查的医疗服务提供者都低估了这些关键干预措施中幸存下来的患者的HRQoL得分.
结论:
- PCICU提供者更愿意接受死亡风险而不是长期发病率,并且不准确地预测患者的HRQoL结果.
- 团队成员之间风险容忍度和结果预测的变化凸显了改善沟通和共享决策的需要.
- 了解这些感知差异对于增强患者与家人的沟通,团队动态和PCICU中的临床决策至关重要.
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