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急症医学能从定性研究方法中学到什么?

What can acute medicine learn from qualitative methods?

作者信息

Heasman Brett, Reader Tom W

机构信息

Department of Social Psychology, London School of Economics and Political Science, London, UK.

出版信息

Curr Opin Crit Care. 2015 Oct;21(5):460-6. doi: 10.1097/MCC.0000000000000234.

Abstract

PURPOSE OF REVIEW

The contribution of qualitative methods to evidence-based medicine is growing, with qualitative studies increasingly used to examine patient experience and unsafe organizational cultures. The present review considers qualitative research recently conducted on teamwork and organizational culture in the ICU and also other acute domains.

RECENT FINDINGS

Qualitative studies have highlighted the importance of interpersonal and social aspects of healthcare on managing and responding to patient care needs. Clear/consistent communication, compassion, and trust underpin successful patient-physician interactions, with improved patient experiences linked to patient safety and clinical effectiveness across a wide range of measures and outcomes. Across multidisciplinary teams, good communication facilitates shared understanding, decision-making and coordinated action, reducing patient risk in the process.

SUMMARY

Qualitative methods highlight the complex nature of risk management in hospital wards, which is highly contextualized to the demands and resources available, and influenced by multilayered social contexts. In addition to augmenting quantitative research, qualitative investigations enable the investigation of questions on social behaviour that are beyond the scope of quantitative assessment alone. To develop improved patient-centred care, health professionals should therefore consider integrating qualitative procedures into their existing assessments of patient/staff satisfaction.

摘要

综述目的

定性方法对循证医学的贡献日益增加,定性研究越来越多地用于考察患者体验和不安全的组织文化。本综述探讨了近期针对重症监护病房(ICU)以及其他急症领域的团队协作与组织文化开展的定性研究。

最新发现

定性研究强调了医疗保健中人际和社会层面因素在管理和应对患者护理需求方面的重要性。清晰/一致的沟通、同情心和信任是患者与医生成功互动的基础,在广泛的衡量标准和结果中,患者体验的改善与患者安全及临床疗效相关。在多学科团队中,良好的沟通有助于达成共同理解、决策和协同行动,在此过程中降低患者风险。

总结

定性方法突显了医院病房风险管理的复杂性,这种复杂性与可用的需求和资源高度相关,并受到多层次社会环境的影响。除了补充定量研究外,定性调查还能够研究仅靠定量评估无法涵盖的社会行为问题。因此,为了发展以患者为中心的优质护理,卫生专业人员应考虑将定性方法纳入其现有的患者/员工满意度评估中。

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