临床医生在第三级心血管疾病护理中应用共享决策的观点,包括多学科心脏团队
Mirjam M Garvelink1, Tom Oirbans2, Lea M Dijksman3
1IQHealthcare, RadboudUMC, Nijmegen, the Netherlands & Department of Value Based Healthcare, St. Antonius Hospital, Nieuwegein, the Netherlands.
International journal of cardiology. Heart & vasculature
|April 11, 2025
概括
医疗保健专业人员很了解共享决策 (SDM),但在心血管疾病 (CVD) 护理方面面临障碍. 干预措施应提高对更好的SDM的认识,沟通和系统支持,特别是在心脏团队内.
科学领域:
- 心脏病学 心脏病学
- 医疗保健管理的管理
- 医学教育 医学教育
背景情况:
- 共享决策 (SDM) 在医疗保健中至关重要,但在心血管疾病 (CVD) 实践中实施具有挑战性.
- 了解医疗保健提供者 (HCP) 对SDM行为和影响心血管疾病因素的看法对于改善至关重要.
- 多学科的心脏团队在心血管疾病护理和SDM实施中发挥着关键作用.
研究的目的:
- 确定医疗保健提供者在心血管疾病 (CVD) 背景下对其共享决策 (SDM) 行为的观点.
- 在常规心血管疾病护理中确定影响SDM实施的因素.
- 探索多学科心脏团队在促进或阻碍SDM方面的作用.
主要方法:
- 在2022年3月至7月期间进行了一项横截面调查.
- 参与者包括来自荷兰两个主要心脏中心的心脏病专家,心胸外科医生,住院医生和护士从业人员.
- 使用描述性统计数据分析了定量数据,并从开放式问题的定性数据进行了主题分析.
主要成果:
- 72名参与者报告了对SDM的高知识 (70%) 和积极态度 (90%),自我报告的适度应用 (SDMQDoc = 73/100).
- 确定的主要障碍是患者和过程特征,包括时间短缺 (70%) 和人员不足 (35%).
- 虽然心脏团队被视为潜在的促进者,但其当前的流程被认为是障碍;管理支持,决策辅助工具和SDM培训被确定为促进者.
结论:
- 医疗人员表现出对SDM的强烈知识和应用,但可能会忽视过程中的关键步骤.
- 需要采取多方面的干预措施,重点是提高意识,沟通技巧和系统级支持.
- 需要进行具体的改进,以优化多学科心脏团队管理的患者的SDM.
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