准则的道德力量:外科医生如何使用基于证据的医学来制他们的干预主义
1Department of Sociology, Northwestern University, Evanston, Illinois, USA.
Sociology of health & illness
|September 30, 2025
概括
外科医生通过解释指南来支持他们的行动来整合基于证据的医学 (EBM). 他们使用EBM来管理患者的期望和委托护理,使手术文化与证据需求相协调.
科学领域:
- 医学社会学 医学社会学
- 医疗保健服务研究 医疗服务研究
- 在外科手术实践中.
背景情况:
- 基于证据的医学 (EBM) 认识论通常被认为与以行动为导向的外科文化相冲突.
- 传统上,外科医生优先考虑果断行动,而不是EBM的沉思性质.
研究的目的:
- 调查外科医生如何采用和将EBM整合到他们的实践中.
- 了解EBM与外科培养相协调的机制.
主要方法:
- 基于证据的临床实践指南 (CPG) 的分析.
- 美国一个学术医疗中心的15名外科医生进行了定性采访.
主要成果:
- 外科医生使用EBM来使他们的干预方法与同行,患者和付款人的要求保持一致.
- EBM在三个关键的手术时刻被使用:手术前 (在会议上解释证据),手术期间 (向患者传达风险) 和手术后 (将护理委托给副专业人员).
- 外科医生将他们的直觉嵌入到EBM中,使用它来管理患者的期望,并利用它进行护理委托.
结论:
- 基于证据的CPG作为外科医生的认识和道德工具.
- 外科医生积极塑造EBM的应用,以促使,预防或委托行动,挑战EBM仅仅是标准化或合理化的观点.
- 外科医生采用EBM反映了证据和实践之间的动态谈判,而不是被动遵守.
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