分享决策在出院规划和长期护理联系:一个回顾性研究
Tzu-Yu Huang1, Hui-Wen Po1, Ying-Chien Chu1
1Department of Nursing, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Journal of the American Medical Directors Association
|November 18, 2025
概括
共享决策 (SDM) 改善了高风险住院患者的长期护理 (LTC) 服务利用率和患者满意度. 遵守SDM计划是防止过早再接收的关键.
科学领域:
- 医疗保健管理的管理
- 患者护理协调与协调
- 医疗保健服务研究 医疗服务研究
背景情况:
- 高风险的住院患者在过渡到长期护理 (LTC) 时经常面临挑战.
- 有效的出院计划对于成功的住院后结果和防止再入院至关重要.
- 共享决策 (SDM) 旨在让患者和护理人员参与护理选择.
研究的目的:
- 评估SDM对高风险住院患者的LTC服务利用率和早期再入院的影响.
- 评估患者和护理人员对SDM促进的出院规划的满意度.
- 确定影响SDM患者再入院率的因素.
主要方法:
- 在台湾的一家医疗中心进行了一项回顾性观察性研究,涉及436名高风险患者 (ADL得分≤65).
- 在放电规划期间使用标准化的SDM决策辅助工具进行合作讨论.
- 通过分析电子病历和国家数据库,比较了接受SDM (n=72) 和不接受SDM (n=364) 的患者之间的结果.
主要成果:
- 在SDM小组中,LTC整合率显著高 (95.4%与82.7%,P<.001),对排放计划的满意度更高.
- 在调整后,SDM和非SDM组之间没有观察到14天再入院的显著差异.
- 在SDM组中,不遵守护理计划与14天的再入院相关,而遵守则导致零的再入院.
结论:
- SDM与改善与LTC服务的连接以及提高排放规划满意度有关.
- 虽然SDM整体上没有显著改变14天再接收率,但遵守SDM框架对于防止早期再接收至关重要.
- SDM对以患者为中心的护理和满意度产生了积极的影响,这表明它对于优化对高风险人群的护理过渡的价值.
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