Manias Elizabeth
Melbourne School of Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
Health Expect. 2015 Oct;18(5):850-66. doi: 10.1111/hex.12057. Epub 2013 Feb 14.
Many patients with complex health-care needs are prescribed several medications on a daily basis. With admission to hospital, patients are often placed in a vulnerable position. Family members can therefore play an important role in supporting patients in decision making about managing medications and negotiating communication exchange with health professionals.
From the perspective of family members, to explore family members' involvement with health professionals and patients about how patients' medications are managed in hospital.
Using an ethnographic design, interviews were conducted with family members of patients admitted to hospital who had at least five medications prescribed in hospital. A purposive sampling approach was used for recruitment. A thematic framework process was used for analysis.
Interviews took place in four surgical and four medical wards in each of two Australian hospitals.
Forty interviews were conducted with family members in relation to their respective relative's medications. Family members tended to participate in passive, rather than active or shared decision-making activities. Those who demonstrated active or shared decision making were extensively involved in managing medications and in addressing problems relating to continuity of care. Communication with health professionals was generally insufficient, despite family members' keenness to speak with them.
Improved communication is needed between family members, health professionals and patients in hospitals. Greater attention should be played by health professionals in initiating communication proactively. Family members possessed valuable, unique information about patients' medications that can be utilized to facilitate patient safety.
许多有复杂医疗需求的患者每天都要服用多种药物。住院后,患者往往处于弱势地位。因此,家庭成员在支持患者进行药物管理决策以及与医护人员协商沟通交流方面可以发挥重要作用。
从家庭成员的角度出发,探讨家庭成员与医护人员及患者就患者住院期间药物管理的参与情况。
采用人种志设计方法,对住院患者中在住院期间至少开具了五种药物的患者的家庭成员进行访谈。采用目的抽样法进行招募。运用主题框架法进行分析。
在澳大利亚两家医院的四个外科病房和四个内科病房进行访谈。
就各自亲属的用药情况,对家庭成员进行了40次访谈。家庭成员倾向于参与被动而非主动或共同决策活动。那些表现出主动或共同决策的人广泛参与了药物管理以及解决与护理连续性相关的问题。尽管家庭成员渴望与医护人员交谈,但与他们的沟通通常不足。
医院中家庭成员、医护人员和患者之间需要改善沟通。医护人员应更加注重主动发起沟通。家庭成员拥有关于患者用药的宝贵且独特的信息,可用于促进患者安全。