临床人员对儿童心室辅助器件的同情性停用的看法
Kimberly A Pyke-Grimm1,2, Michelle Brown3, Alaa Youssef4
1From the Department of Nursing Research and Evidence-Based Practice, Center for Professional Excellence and Inquiry, Stanford Medicine Children's Health, Palo Alto, California.
概括
儿童临床医生在决定关闭心室辅助器件 (VAD) 时面临道德困境. 了解临床医生的观点对于制定儿童VAD禁用指南至关重要.
科学领域:
- 儿童心脏病学
- 缓和护理
- 医学伦理
背景情况:
- 室内辅助器件 (VAD) 的使用在儿科患者中正在增加.
- 家庭和临床医生对VAD支持的可取性存在差异.
- 不良事件可能会影响患者的生活质量,并迅速重新评估VAD支持.
研究的目的:
- 探讨儿科心力衰竭临床医生对VADs同情性失活 (CD) 过程的观点.
- 确定与儿童患者CD-VAD决策相关的挑战和主题.
- 为儿童特定的VAD禁用指南制定信息.
主要方法:
- 使用半结构面试进行定性研究.
- 21名儿童心力衰竭临床医生参与了这项研究.
- 面试的重点是与CD-VAD相关的过程和经验.
主要成果:
- 确定的主题是"决定使用CD-VAD".
- 五个新兴类别:沟通策略,人际关系和信任,时间的重要性,情感损失,以及重定向护理.
- 临床医生报告说,由于患者的痛苦和决策不一致,
结论:
- 在CD-VAD决策中达成共识是通过涉及家庭的团队讨论.
- 了解临床医生的挑战对于制定综合儿科息护理指南至关重要.
- 在儿童VAD患者可能需要CD-VAD时,需要适当的指导.
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