乌干达东部农村卫生设施的患者和医疗保健提供者之间的共同决策:一项探索性定性研究
Ranga Solomon Owino1, Olivia Kituuka2, Paul Kutyabami3
1Makerere University Lung Institute, Kampala, Uganda. rangasolomon@gmail.com.
BMC medical ethics
|January 28, 2025
概括
患者希望在农村医疗保健中分享决策,但文化障碍和提供者培训缺口阻碍了参与. 需要采取干预措施来改善患者参与,并解决医疗保健中的伦理问题.
科学领域:
- 提供医疗保健服务.
- 医学伦理学医学伦理学
- 患者的参与度 患者的参与度
背景情况:
- 共享决策 (SDM) 对于患者在医疗保健中的知情选择至关重要.
- 由于其对生活的影响,患者参与健康决策至关重要.
- 本研究考察了乌干达农村环境中的SDM经验和伦理.
研究的目的:
- 探索患者和医疗保健提供者在乌干达东部农村的共同决策方面的经验.
- 识别共同决策过程中遇到的挑战和伦理问题.
- 为提高患者参与医疗保健决策的策略提供信息.
主要方法:
- 采用了一种探索性定性研究设计.
- 对12名医疗保健提供者和11名患者进行了23次深入采访.
- 使用NVivo-12 plus软件进行了主题分析.
主要成果:
- 出现了四个主题:父式关怀,挑战,改进策略和道德问题.
- 患者表达了参与的愿望,但报告参与度低.
- 障碍包括文化习惯,男性参与度低,父权主义态度;伦理问题涉及同意,隐私,欺骗和伤害.
结论:
- 提高患者意识和提供者培训是必要的,以解决SDM的伦理问题.
- 包括手册和持续培训在内的有针对性的干预措施可以改善患者的伦理参与.
- 进一步的研究应该调查更大的设施和更年轻的患者群体.
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