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与患者讨论癫痫猝死(SUDEP):医疗保健提供者的实践。

Discussing sudden unexpected death in epilepsy (SUDEP) with patients: practices of health-care providers.

机构信息

Department of Science of Nursing Care, Indiana University School of Nursing, 1033 East Third Street, Bloomington, IN 47405, USA.

Indiana University School of Nursing, 1111 Middle Drive, Indianapolis, IN 46202, USA.

出版信息

Epilepsy Behav. 2014 Mar;32:38-41. doi: 10.1016/j.yebeh.2013.12.020. Epub 2014 Jan 24.

Abstract

There is a lack of consensus regarding how health-care providers should address SUDEP with patients. The purpose of this study was to describe various health-care providers' practices regarding discussion of SUDEP with patients. Separate focus groups were conducted with epileptologists, neurologists, and advanced practice nurses. Across all disciplines, reasons for discussing SUDEP included Practical Accountability, Moral Accountability, Proactivity, and Reactivity. For nurses only, an additional reason was Patient Advocacy. In terms of when not to discuss SUDEP, for all disciplines, and especially the physicians, the theme Not at First emerged. Additional themes that emerged for this question included, in the case of neurologists and epileptologists, Moral Accountability and Out of Options. Ways in which SUDEP is discussed included, in all groups, Discussion and Written Materials. In addition, prevalent in all groups was the finding that procedures for discussing SUDEP with patients and families need to be somewhat standardized. Implications for practice are discussed.

摘要

关于医疗保健提供者应如何与患者讨论 SUDEP,目前尚无共识。本研究的目的是描述不同医疗保健提供者在与患者讨论 SUDEP 方面的各种做法。分别对癫痫专家、神经科医生和高级执业护士进行了焦点小组讨论。在所有学科中,讨论 SUDEP 的原因包括实际责任、道德责任、主动性和反应性。仅对护士而言,还有一个额外的原因是患者倡导。在不讨论 SUDEP 的情况下,对于所有学科,尤其是医生,出现了“非首次”的主题。对于这个问题,还出现了其他主题,包括在神经科医生和癫痫专家的情况下,出现了道德责任和别无选择。讨论 SUDEP 的方式包括在所有组中,讨论和书面材料。此外,在所有组中都发现,与患者和家属讨论 SUDEP 的程序需要进行一定程度的标准化。讨论了对实践的影响。

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本文引用的文献

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Unifying the definitions of sudden unexpected death in epilepsy.统一癫痫性猝死的定义。
Epilepsia. 2012 Feb;53(2):227-33. doi: 10.1111/j.1528-1167.2011.03358.x. Epub 2011 Dec 22.
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Sudden, unexpected death in epilepsy.癫痫猝死
N Engl J Med. 2011 Nov 10;365(19):1801-11. doi: 10.1056/NEJMra1010481.
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What can be done to reduce the risk of SUDEP?
Epilepsy Behav. 2010 Jul;18(3):137-8. doi: 10.1016/j.yebeh.2010.04.046.
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Sudden unexpected death in epilepsy (SUDEP): don't ask, don't tell?癫痫猝死(SUDEP):不闻不问?
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