利用重症患者替代决策者的实际经验来开发决策支持干预措施。
Leveraging the lived experience of surrogate decision makers of the seriously ill to develop a decision support intervention.
作者信息
Hickman Ronald L, Daly Barbara J, Clochesy John M, O'Brien Julia, Leuchtag Mary
机构信息
School of Nursing, Case Western Reserve University, Cleveland, OH.
School of Nursing, Case Western Reserve University, Cleveland, OH.
出版信息
Appl Nurs Res. 2016 May;30:67-9. doi: 10.1016/j.apnr.2015.10.012. Epub 2015 Oct 28.
BACKGROUND
Surrogate decision makers of seriously ill patients are frequently asked to make healthcare decisions without evidence-based decision support.
AIMS
To describe the lived experiences of surrogate decision makers who have made advance care decisions and identify relevant features of a decision support intervention from their perspectives.
METHODS
A convenience sample of surrogate decision makers (n=10) of seriously ill patients discharged to an extended care facility within the past 6 months participated in focus group discussions. Data were analyzed using content analysis.
RESULTS
Three salient themes were identified: (1) limited preparation, (2) decisional and emotional burden, and (3) content and features of a decision support intervention.
CONCLUSIONS
Surrogate decision makers of the seriously ill are not prepared for their new role, and experience decisional and emotional burden. Effective decision support interventions must address the decisional and emotional needs of surrogate decision makers to enhance the quality of their decisions.
背景
重症患者的替代决策者经常被要求在没有循证决策支持的情况下做出医疗保健决策。
目的
描述已做出预先护理决策的替代决策者的生活经历，并从他们的角度确定决策支持干预措施的相关特征。
方法
对过去6个月内出院至长期护理机构的重症患者的替代决策者（n = 10）进行便利抽样，参与焦点小组讨论。采用内容分析法对数据进行分析。
结果
确定了三个突出主题：（1）准备不足，（2）决策和情感负担，以及（3）决策支持干预措施的内容和特征。
结论
重症患者的替代决策者对其新角色没有做好准备，并经历决策和情感负担。有效的决策支持干预措施必须满足替代决策者的决策和情感需求，以提高其决策质量。
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