Rolnick Sharon, Bliss Donna Z, Jackson Jody M, Arntson Casey, Mullins Jean, Hepburn Kenneth
HealthPartners Institute of Education and Research, Bloomington, MN, USA.
Ostomy Wound Manage. 2013 Apr;59(4):62-7.
Communication between healthcare providers and patients/family caregivers about incontinence and associated skin damage is wanting, and information about healthcare providers perspectives on improving this communication is limited. A descriptive study was conducted using semi-structured, tape-recorded interviews with 11 healthcare providers with clinical expertise in geriatrics and dementia working in a large integrated healthcare system. The survey was developed by the authors based on a review of the relevant literature with guidance from a three-member Advisory Committee and consisted of nine open-ended questions related to communication with patients and families about incontinence and skin damage. Specifically, information was obtained about providers' perspectives on the timing of inquiring about these problems, how best to tailor language and approach the topic, barriers and facilitators to discussion of incontinence, and recommendations for educational and supportive resources. Responses were analyzed using a content analysis approach. Using a purposeful sampling technique, 11 experienced healthcare professionals agreed to participate in the study. Main themes observed included: 1) incontinence issues are not routinely or voluntarily addressed by all providers, 2) caregivers are receptive to discussion if the topic is broached by patient/caregiver, and 3) main barriers to providing information include limited clinician time and patient/family caregiver embarrassment. Participant clinicians expressed interest in readily available, single-topic, printed patient/caregiver-focused educational materials to enhance patient-provider communication and serve as a resource. These materials were subsequently developed. Further research is warranted to test the effectiveness of the recommendations and the materials developed as a result of the study.
医疗服务提供者与患者/家庭护理人员之间关于失禁及相关皮肤损伤的沟通存在不足,而且关于医疗服务提供者对改善这种沟通的看法的信息也很有限。本研究采用描述性研究方法,对在一个大型综合医疗系统中工作的11名具有老年病学和痴呆症临床专业知识的医疗服务提供者进行了半结构化的录音访谈。该调查问卷由作者根据相关文献综述,并在一个三人咨询委员会的指导下编制而成,包括九个与向患者和家属沟通失禁及皮肤损伤相关的开放式问题。具体而言,获取了关于医疗服务提供者对询问这些问题的时机、如何最好地调整语言和探讨该话题、失禁讨论的障碍和促进因素以及教育和支持资源建议的看法。采用内容分析法对回复进行分析。采用目的抽样技术,11名经验丰富的医疗专业人员同意参与该研究。观察到的主要主题包括:1)并非所有医疗服务提供者都会定期或主动提及失禁问题;2)如果由患者/护理人员提出该话题,护理人员愿意进行讨论;3)提供信息的主要障碍包括临床医生时间有限以及患者/家庭护理人员感到尴尬。参与研究的临床医生表示有兴趣获得现成的、单一主题的、以患者/护理人员为重点的印刷教育材料,以加强医患沟通并作为一种资源。随后编制了这些材料。有必要进行进一步研究,以测试这些建议以及因本研究而编制的材料的有效性。