在安全网医院中实施和评估"三愿"项目:混合有效性实施研究的协议
Thanh H Neville1, Anne Walling1,2, Neil S Wenger1
1David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America.
PloS one
|May 2, 2025
概括
三个愿望项目 (3WP) 可以适应安全网医院 (SNHs),以改善生命终端 (EOL) 护理. 这项研究评估了它对ICU患者家庭和临床医生的影响.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 息护理干预改善了重症监护病房 (ICU) 的生命末期 (EOL) 经验.
- 安全网医院 (SNH) 服务于低收入和没有保险的人群,但往往缺乏强大的EOL护理干预措施.
- 三个愿望项目 (3WP) 是一个低成本的干预,旨在通过满足患者的愿望来增强富有同情心的EOL护理.
研究的目的:
- 在洛杉矶的三个SNH实施和评估3WP.
- 评估3WP对EOL护理质量的可行性和影响,丧亲家庭的心理痛苦和临床医生倦怠.
主要方法:
- 一个务实的集群随机化阶梯型2混合有效性-实施研究设计.
- 对丧亲家庭 (死后3个月) 和护士 (实施前,6个月和12个月后) 的调查.
- 使用RE-AIM框架进行混合方法评估,包括与家庭和护士进行半结构面试.
主要成果:
- 假设在SNH中适应和实施3WP的可行性.
- 评估3WP在改善SNH环境中的EOL护理方面的有效性.
- 确定必要的调整,以量身定制SNHICU中的息护理干预措施.
结论:
- 3WP对提高SNH重症监护室中EOL护理的承诺显示出了希望.
- 这项研究将为适应弱势群体的息护理干预提供关键的见解.
- 成功实施可以改善对临终患者及其家属在资源有限的环境中的同情护理.
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