关于疑似甲状腺骨折的建议与患者和外科医生的舒适性有关,与不确定性有关
Floor A Davids1, David Ring, Job N Doornberg
1From the Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX (Davids and Ring), and the Department of Orthopedic Surgery and Trauma Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen, Groningen, the Netherlands (Doornberg).
The Journal of the American Academy of Orthopaedic Surgeons
|August 8, 2025
概括
外科医生和患者对不确定性的容忍度会影响骨骨折的管理. 解决外科医生的不确定性和患者因素可以减少怀疑骨骨折的治疗策略的变化.
科学领域:
- 整形外科手术 整形外科手术
- 医疗决策的制定 医疗决策的制定
- 患者管理 患者管理
背景情况:
- 在管理疑似骨骨折的变化是常见的.
- 患者和外科医生的因素,包括对不确定性的耐受性,可能会导致这种变化.
- 了解这些因素对于标准化护理至关重要.
研究的目的:
- 评估患者和外科医生对不确定性的耐受性对疑似骨骨折的管理策略的影响.
- 确定与管理选择相关的患者和外科医生因素.
- 确定影响外科医生对患者主导决策的舒适度的因素.
主要方法:
- 与外科医生一起进行了基于场景的调查实验.
- 外科医生完成了不确定性不耐受度表 (IUS-12).
- 对外科医生提出了8种随机患者因子的临床情景,他们建议患者进行管理,并对患者决策的舒适性进行评价.
主要成果:
- 额外的成像,最常见的策略 (50%),与较高的损伤能量,疼痛强度,较低的患者不确定性容忍度,以及患者更愿意返回工作相关联.
- 对患者主导决策的外科医生较低的舒适度与更高的疼痛强度和更低的外科医生对不确定性的容忍度有关.
- 患者和外科医生对不确定性的舒适性显著影响了管理建议.
结论:
- 为了减少怀疑骨骨折管理的变化,需要解决外科医生对不确定性的容忍.
- 策略应考虑患者对不确定性和症状强度的容忍度.
- 提高外科医生对不确定性和对症状-病理生理学差异的认识的舒适度是关键.
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