认知关怀目标的必要性 严重病重的外科病人之间的谈话
Nicole Meredyth1, Yangzi Liu2, Diane Haddad3
1Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Penn Medicine, Philadelphia, Pennsylvania; Department of Surgery, Northwestern Medicine, Chicago, Illinois.
The Journal of surgical research
|February 1, 2025
概括
认识到终身护理需求至关重要. 外科提供者和那些接受过更多培训的人更有可能讨论重症患者的护理目标 (GoC).
科学领域:
- 医学伦理 医学伦理
- 手术护理 手术护理
- 抚慰性护理是一种缓解性护理.
背景情况:
- 有效的终身护理认可对于预防患者的痛苦和降低医疗保健成本至关重要.
- 在手术护理中的治愈意图可能会掩盖患者和家人的愿望,特别是伴随性疾病.
- 这项研究调查了对有生命终端需求的手术患者的护理目标 (GoC) 对话的优先级.
研究的目的:
- 为了评估关怀的目标 (GoC) 会话的频率,在关心重症手术患者的提供者之间.
- 确定提供者级别和专业是否会影响GOC讨论的优先级.
- 确定与手术环境中及时启动终身护理讨论相关的因素.
主要方法:
- 一个城市学术中心的123名提供者审查了重症外科患者的五个病例.
- 参与者被要求为每个患者确定至少三项护理优先事项.
- 分析了回复,以确定优先考虑护理目标 (GoC) 的频率.
主要成果:
- 77.2%的参与者至少一次优先考虑了GOC,优先考虑因场景而异.
- 外科提供者 (83.1%) 比非外科提供者 (67.4%) 更有可能优先考虑GoC.
- 更高的研究生年 (PGY) 水平与更高的GOC优先级相关 (90.9%的PGY5-9对比60.9%的PGY1-4).
结论:
- 提供者确定GOC作为优先事项的能力各不相同.
- 研究生年 (PGY) 水平的增加与家庭工作人员优先考虑GoC的可能性更高有关.
- 外科提供者比非外科提供者更频繁地优先考虑GoC,可能是由于熟悉外科条件.
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