评估在初级保健中共享决策的实施:一项针对未预告的标准化患者的研究
Mahima Khan1, Shelley Yu1, Abigail Henderson1
1Department of Medicine, NYU Grossman School of Medicine, Division of General Internal Medicine and Clinical Innovation, New York, New York, USA.
医生根据临床主题不同地使用共享决策 (SDM). 戒烟的SDM得分高于胃食道逆流症 (GERD),这表明主题特定的应用.
科学领域:
- 医学教育 医学教育
- 临床交流 临床沟通
- 健康行为研究 研究健康行为研究
背景情况:
- 共享决策 (SDM) 是以患者为中心的护理的基石,临床指南建议.
- 然而,在各种临床场景中,临床医生对SDM的一致应用仍然是一个挑战.
- 具体临床主题对SDM实践的影响还不清楚.
研究的目的:
- 调查临床主题如何影响住院医生的共享决策 (SDM) 应用.
- 为了比较SDM参与关于胃食道逆流性疾病 (GERD) 和戒烟的讨论.
主要方法:
- 未预告的标准化患者 (USP) 模拟了GERD和戒烟的新患者访问.
- 住院医生的互动被录音并使用观察员OPTION-5工具评估SDM质量.
主要成果:
- 与GERD管理相比,在戒烟讨论期间,SDM得分明显更高.
- 居民更一致地将患者的偏好纳入戒烟讨论中.
- 相反,居民在GERD管理咨询期间提供了更多信息.
结论:
- 医生SDM行为似乎根据临床背景进行了调整,证明了主题依赖的应用.
- 需要教育策略来应对这种变化,并确保在日常和行为复杂问题上平衡SDM实施.
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