探索患者对急诊室预先护理规划干预的看法:一种定性研究
Youkie Shiozawa1, Saaya Morton1, Nanako Shirai2
1Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
概括
在ED GOAL干预成功地激励重病患者开始提前护理计划 (ACP) 对话. 障碍包括临床医师的可用性和患者的准备,这表明需要量身定制的ACP方法.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急部门 (ED) 访问为重病患者提供了讨论未来医疗保健目标的机会.
- 治疗ED的临床医生往往缺乏启动预先护理计划 (ACP) 对话的实际策略.
- 该ED GOAL干预计划旨在让临床稳定,重病的老年人与门诊医生进行讨论.
研究的目的:
- 探索干预臂参与者对ED GOAL干预的感知好处和障碍.
- 了解患者在ED GOAL干预后启动和继续ACP的经验.
主要方法:
- 从2022年10月到2024年8月,与52名干预组患者 (50岁以上) 进行了半结构面试.
- 用快速的定性分析来确定与干预的好处和阻碍正在进行的ACP相关的主题.
- 研究参与者从马萨诸塞州波士顿的三家医院招募.
主要成果:
- ED GOAL干预激励了大多数患者与临床医生和亲人开展ACP,改善了对话质量和患者与临床医生的关系.
- 继续ACP的主要障碍包括缺乏临床医生的可用性和患者/代孕产妇的准备.
- 那些已经有了明确的治疗目标的患者发现这种干预不那么有益,却是无害的.
结论:
- 在ED GOAL干预提供了可操作的洞察力,以预先计划护理.
- 建议通过非医生临床医生或替代资源来解决临床医生的可用性.
- 定制ACP干预措施可以提高患者的准备和参与度.
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