临床医生对重症监护病房中沟通促进者有用性的看法。
Clinicians' perceptions of the usefulness of a communication facilitator in the intensive care unit.
作者信息
Howell Abigail A, Nielsen Elizabeth L, Turner Anne M, Curtis J Randall, Engelberg Ruth A
机构信息
Abigail A. Howell and Elizabeth L. Nielsen are both researchers with the end-of-life care research program in the Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle. Ruth A. Engelberg is a research associate professor in the Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle. Anne M. Turner is an assistant professor in the Department of Health Services, School of Public Health, and an assistant professor in the Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle. J. Randall Curtis is a professor, the A. Bruce Montgomery-American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine in the Division of Pulmonary and Critical Care, Department of Medicine and an adjunct professor in the Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle.
出版信息
Am J Crit Care. 2014 Sep;23(5):380-6. doi: 10.4037/ajcc2014517.
BACKGROUND
Despite its documented importance, communication between clinicians and patients' families in the intensive care unit often fails to meet families' needs, and interventions to improve communication are needed. Use of a communication facilitator-an additional staff member-to improve communication between clinicians and patients' families is the focus of an ongoing randomized trial. The clinical team's acceptance of the communication facilitator as an integral part of the team is important.
OBJECTIVES
To explore clinicians' perceptions of the usefulness of a communication facilitator in the intensive care unit.
METHODS
Fourteen semistructured qualitative interviews to assess perspectives of physicians, nurses, and social workers who had experience with the communication facilitator intervention on the intervention and the role of the facilitator. Methods based on grounded theory were used to analyze the data.
RESULTS
Clinicians perceived facilitators as (1) facilitating communication between patients' families and clinicians, (2) providing practical and emotional support for patients' families, and (3) providing practical and emotional support for clinicians. Clinicians were enthusiastic about the communication facilitator but concerned about overlapping or conflicting roles.
CONCLUSIONS
Clinicians in the intensive care unit saw the facilitator intervention as enhancing communication and supporting both patients' families and clinicians. They also identified the importance of the facilitator within the interdisciplinary team. Negative perceptions about the use of a facilitator should be addressed before the intervention is implemented, in order to ensure its effectiveness.
背景
尽管已有文献证明其重要性，但重症监护病房中临床医生与患者家属之间的沟通往往无法满足家属的需求，因此需要采取干预措施来改善沟通。使用沟通协调员（一名额外的工作人员）来改善临床医生与患者家属之间的沟通是一项正在进行的随机试验的重点。临床团队将沟通协调员视为团队不可或缺的一部分，这一点很重要。
目的
探讨临床医生对重症监护病房中沟通协调员作用的看法。
方法
进行了14次半结构化定性访谈，以评估有沟通协调员干预经验的医生、护士和社会工作者对该干预措施及协调员角色的看法。采用基于扎根理论的方法对数据进行分析。
结果
临床医生认为协调员的作用包括：（1）促进患者家属与临床医生之间的沟通；（2）为患者家属提供实际和情感支持；（3）为临床医生提供实际和情感支持。临床医生对沟通协调员充满热情，但担心角色重叠或冲突。
结论
重症监护病房的临床医生认为协调员干预措施能够加强沟通，并为患者家属和临床医生提供支持。他们还认识到协调员在跨学科团队中的重要性。在实施干预措施之前，应解决对使用协调员的负面看法，以确保其有效性。
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