关于主要下肢截肢的共享决策的挑战:PERCEIVE定性研究
Hayley Prout1, Cherry-Ann Waldron2, Brenig Gwilym3
1Centre for Trials Research, Cardiff University School of Medicine, Cardiff, Cardiff, UK ProutH@cardiff.ac.uk.
BMJ open
|January 12, 2026
概括
由于患者的理解和专业实践,重大下肢截肢的共享决策面临挑战. 培训医疗保健专业人员对于提高患者的信心和对截肢决定的知情同意至关重要.
科学领域:
- 血管外科 血管外科
- 患者的决策能力
- 质量健康研究 质量健康研究
背景情况:
- 主要的下肢截肢是慢性肢体威胁性缺血或糖尿病足的高风险决定.
- 倡导共享决策 (SDM),但其在截肢中的应用尚不清楚.
研究的目的:
- 探索主要下肢截肢的沟通,同意,风险预测和决策过程.
- 在这种情况下,研究有效的SDM所面临的挑战.
主要方法:
- 使用与患者和医疗保健专业人员进行半结构面试的定性研究.
- 对面试成绩单进行主题分析.
- 在英国血管中心进行的研究 (2020-2022).
主要成果:
- 确定了五个挑战类别:有限的患者理解,可变的患者态度,专业挑战,外科医生父权主义和决策后悔.
- 这些因素阻碍了截肢案件的有效共享决策.
结论:
- 主要的下肢截肢涉及改变生活的决定,具有重大后果.
- 对SDM的挑战仍然存在,需要为医疗保健专业人员提供有针对性的培训.
- 加强培训可以提高患者的信心和明智的决策.
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