可持续麻醉实践的障碍和促进因素:混合方法研究
Carys Batcup1, Aws Almukhtar2, Aarya Menon3
1Dyson School of Design Engineering, Imperial College London, London, UK; Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands.
可持续的麻醉实践是减少医疗保健的关键.
科学领域:
- 麻醉学 麻醉学
- 医疗保健的可持续性 医疗保健的可持续性
- 行为科学 行为科学
背景情况:
- 医疗保健对环境的影响受到麻醉实践的重大影响.
- 局部/区域麻醉和全静脉麻醉 (TIVA) 分别为全身麻醉和吸入剂提供更可持续的替代品.
- 了解麻醉选择背后的驱动因素对于促进更绿色的做法至关重要.
研究的目的:
- 调查为什么总麻醉有时比局部/区域麻醉更受欢迎的原因.
- 探索影响选择吸入麻醉而不是TIVA的因素.
- 确定对麻醉实践的行为影响,以提高可持续性.
主要方法:
- 在英国进行了一项混合方法研究 (2023年6月至2024年4月).
- 使用框架分析分析了麻醉师,外科医生和护士的半结构面试 (n=19).
- 根据采访结果制定了一项全国性调查 (n=347),并对其进行了定量和定性分析.
主要成果:
- 出现了四个主要主题:背景因素,患者差异/偏好,决策者影响和默认做法/信任问题.
- 这些主题包括17个子主题,并映射到理论领域框架的9个领域.
- 行为和系统障碍显著影响麻醉决策.
结论:
- 对行为影响的洞察力可以指导对可持续麻醉的干预,而不会影响患者的安全.
- 通过专门列表解决障碍,改善沟通,培训和技术可以提高效率和以患者为中心的护理.
- 与临床医生和患者共同设计未来的干预措施对于临床可接受性和可行性至关重要.
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