临床决策疲劳:一个系统和范围审查与元合成
Nicola Grignoli1,2,3, Greta Manoni3, Jvan Gianini3
1Cantonal Sociopsychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino, Mendrisio, Switzerland nicola.grignoli@ti.ch.
Family medicine and community health
|February 8, 2025
概括
决策疲劳 (DF) 损害了临床判断,增加了医疗错误. 本综述综合了DF决定因素和后果的研究,强调需要明确的定义和有针对性的干预措施,以减轻其对医疗保健专业人员的影响.
科学领域:
- 医学决策和认知科学.
- 医疗保健质量和患者安全研究.
背景情况:
- 决策疲劳 (DF) 是一个越来越严重的问题,可能会损害临床判断,降低诊断准确度,并增加医疗错误.
- 在临床环境中对DF的现有研究是有限的,缺乏对其定义,测量和影响因素的全面理解.
研究的目的:
- 建立一个全面的框架,以了解医疗环境中的决策疲劳 (DF) 的定义和测量.
- 确定临床DF的关键决定因素和后果,包括在之前的审查中经常被忽视的激励因素.
主要方法:
- 一个系统和范围审查 (ScR) 采用元合成.
- 包括临床DF影响医疗决策的经验和非经验论文,涉及全球医生.
- 遵守系统审查和元分析 (PRISMA) 范围审查清单的首选报告项目.
主要成果:
- 分析了43篇论文,其中25篇是经验性,主要是涉及欧洲/英国和北美居民的定量研究.
- 内部医学和初级保健是最常被研究的学科,DF经常被间接评估.
- 临床DF受到交织的认知,情感,行为,社会和伦理决定因素的影响,并确定了风险,保护因素和负面结果.
结论:
- 该审查提供了强有力的证据,证明需要明确,连贯的临床DF的定义.
- 制定这样的定义对于实施有针对性的预防性干预措施来解决医疗保健机构中的DF至关重要.
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