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在急诊外科手术中,患者对共享决策的观点
Rachel Spence1, Susan Joan Moug1,2, Meghan Minnis1
1University of Glasgow, Glasgow, Scotland.
概括
紧急整形外科 (EGS) 的患者往往不理解共享决策 (SDM) 并依赖外科医生做决定. 这突显了在EGS中实施SDM的障碍,影响了患者的同意.
科学领域:
- 医学伦理 医学伦理
- 手术患者护理手术患者护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 共享决策 (SDM) 是患者同意的首选模式,但其在紧急普通手术 (EGS) 中的应用研究不足.
- 在EGS的独特背景下,人们对患者对SDM的看法和经验的理解有限.
研究的目的:
- 探索EGS患者对SDM的理解.
- 在EGS中识别与SDM相关的患者观点和经验.
- 发现EGS中患者和临床医生的SDM实施的潜在障碍.
主要方法:
- 这是一项两部分的研究,包括一个范围审查,然后是患者和公众参与 (PPI) 练习.
- 范围审查确定了现有文献,并为PPI讨论点的发展提供了信息.
- 专题分析用于分析来自患者和支持者讨论的定性数据.
主要成果:
- 范围审查显示,在EGS和患者视角中,SDM的证据很少.
- 患者参与者对手术风险指标如"30天死亡率"一无所知,并感到时间压力压倒了他们.
- 大多数患者将决策推迟到外科医生,优先考虑他们的判断,而不是个人偏好.
结论:
- 这项研究提供了第一个报告的患者洞察到在EGS设置中的SDM.
- 确定了SDM实施的重大障碍,包括缺乏患者理解和风险意识.
- 进一步的研究至关重要,以加强SDM的采用,作为EGS患者同意的标准.
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