外科医生和新生儿科医生对生死性肠球炎手术决策的看法
George S Bethell1,2, Nigel J Hall3,2, Cheryl Battersby4,5
1University Surgical Unit, Faculty of Medicine, University of Southampton, Southampton, UK g.s.bethell@soton.ac.uk.
Archives of disease in childhood. Fetal and neonatal edition
|April 25, 2025
概括
死亡性肠球炎 (NEC) 的手术决策是具有挑战性的,因为诊断的不确定性和恐惧. 标准化实践和提高客观性是必要的,以改善对NEC的婴儿的护理.
科学领域:
- 新生儿手术 新生儿手术
- 儿科外科手术 儿科外科手术
- 临床决策的过程
背景情况:
- 死性肠球炎 (NEC) 在手术决策中提出了重大挑战.
- 目前的做法缺乏标准化和客观性,导致临床医生遇到困难.
研究的目的:
- 调查NEC手术决策的复杂性.
- 确定影响这些决策的因素,并探索优化途径.
主要方法:
- 三个半结构化的焦点小组由22名咨询参与者 (15名儿科外科医生,7名新生儿科医生) 组成.
- 应用了反思性的专题分析来关注组的成绩单.
主要成果:
- 十个主题详细介绍了为NEC决策提供信息的因素;六个突出挑战包括诊断不确定性,可变的转诊门,缺乏护理连续性,不清楚的手术标准和恐惧.
- 恐惧的子主题包括对不良结果的担忧,同事的批评和不必要的手术.
- 主题与婴儿,临床医生和系统因素相关,强调干预,转诊和减少实践变异性的指示.
结论:
- 这项研究揭示了新生儿科医生和外科医生在NEC手术决策中所面临的困难.
- 临床医生希望实践标准化和更大的客观性来改善结果.
- 结果可以指导未来的研究和实践变化,以便更早,准确的NEC决策.
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