在神经重症监护病房开发基于网络和移动的共享决策工具
Winnie L Liu1, Lidan Zhang2, Soussan Djamasbi3
1Johns Hopkins University School of Medicine, Baltimore, MD, USA.
概括
为严重急性脑损伤患者做出关键护理决定的家庭面临沟通挑战. 数字决策辅助工具可以通过改善信息交换和与患者价值观调整护理来支持共享决策 (SDM).
科学领域:
- 神经学 神经学
- 医学伦理 医学伦理
- 医疗信息学 医疗信息学
背景情况:
- 严重急性脑损伤 (SABI) 患者在神经急症监护室环境中无法做出医疗保健决策.
- 代理决策者,通常是家庭,承担着重大负担,包括情绪上的痛苦和沟通障碍.
- 现有的挑战包括预后不确定性,时间压力和难以理解患者价值观.
研究的目的:
- 审查SABI患者临床医生与家庭沟通的挑战.
- 探索共享决策 (SDM) 作为改善沟通和代理授权的框架.
- 突出数字决策辅助器 (DAs) 在促进神经急症监护室SDM中的作用和优势.
主要方法:
- 文献综述侧重于神经急症监护室中临床医生与家庭的沟通.
- 分析共享决策 (SDM) 原则及其应用.
- 与传统方法相比,数字决策辅助工具 (DA) 的评估.
主要成果:
- 共享决策 (SDM) 为信息交换和审议提供了一个结构化的方法.
- 数字决策辅助工具 (DA) 显示出与纸质版本相比的潜在优势,包括增强的可访问性和交互性.
- 新兴技术可以进一步提高神经急症监护室设置中的DA的有效性.
结论:
- 需要改进指导和工具,以支持神经急症监护室的代孕决策.
- 数字决策辅助工具是有希望的工具,可以促进共享决策 (SDM) 和改善临床医生与家庭的沟通.
- 建议在神经急症监护室环境中进一步开发和整合数字DA.
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