泰国和美国急诊医生之间的代码状态对话的方法比较:一项调查研究
Thidathit Prachanukool1,2, Pongsakorn Atiksawedparit3, Suthasinee Senasu4
1Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA thidathit.pra@mahidol.ac.th.
Emergency medicine journal : EMJ
|June 15, 2025
概括
美国和泰国的急诊医生将代码状态对话的重点放在程序上,而不是个人价值观上. 沟通方法的具体差异可能反映在终身护理讨论中不同的文化影响.
科学领域:
- 医学沟通 医学沟通
- 跨文化医疗研究 跨文化医疗研究
- 抚慰性护理是一种缓解性护理.
背景情况:
- 紧急诊所医生参与关键的代码状态对话,以共同决策限制生命的疾病.
- 社会文化规范和医疗保健系统在这些敏感讨论期间显著影响沟通.
研究的目的:
- 调查和比较美国和泰国急诊医生在进行代码状态对话时的方法.
- 确定临床医生讨论维持生命治疗方法的潜在文化差异.
主要方法:
- 美国和泰国医院的急诊医生进行了横截面调查 (2021年12月至2022年11月).
- 该调查使用5点的利克特级别来评估代码状态对话的基于程序和基于价值的组件.
- 后勤回归分析比较了美国和泰国临床医生之间的沟通实践,控制了混变量.
主要成果:
- 超过50%的临床医生经常在谈话中包含基于程序的组件,但很少包含基于价值的组件.
- 与泰国临床医生相比,美国临床医生更有可能讨论重启心脏,但不太可能询问血管压缩剂偏好或提供建议.
- 泰国临床医生比美国临床医生更有可能评估基线活动并提供建议.
结论:
- 美国和泰国的急诊医生都在代码状态对话中优先讨论程序而不是个人价值观.
- 两组人群之间沟通策略的明显差异表明,生命终结决策的文化基础有所不同.
- 需要进一步的研究来理解和解决这些文化细微差别,以改善以患者为中心的护理.
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