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迈向医院实施预先医疗照护计划:医院专业人员应参与吗?

Toward Hospital Implementation of Advance Care Planning: Should Hospital Professionals Be Involved?

机构信息

1 University Hospitals Leuven, Leuven, Belgium.

2 KU Leuven, Leuven, Belgium.

出版信息

Qual Health Res. 2018 Feb;28(3):456-465. doi: 10.1177/1049732317735834. Epub 2017 Oct 23.

Abstract

In Belgium, Advance Care Planning (ACP) is not well implemented in hospital practice. One of the premises for successful implementation is involving the adopters in the implementation process. In hospital, important adopters of ACP are physicians, nurses, social workers, and psychologists. First, this study wants to understand what the characteristics are of ACP in hospital, according to professionals. Second, this study aims to give an insight in the experienced value of ACP. Third, the experienced barriers to have ACP conversations are explored. Twenty-four interviews were taken and analyzed with Content Analysis based on Grounded Theory. Three independent external auditors surveilled the analysis. ACP in hospital exists by the grace of the initiative of the actors involved in the case. Professionals perceive fields of tension between one another; barriers to ACP communication. ACP is mainly considered valuable because it is a process that creates time for exploration and reflection.

摘要

在比利时,预先医疗指示(ACP)在医院实践中并未得到很好的实施。成功实施的前提之一是让采用者参与实施过程。在医院中,ACP 的重要采用者是医生、护士、社工和心理学家。首先,本研究旨在了解根据专业人员的说法,医院中的 ACP 有哪些特点。其次,本研究旨在深入了解 ACP 的经验价值。第三,探讨了进行 ACP 对话所面临的经验障碍。进行了 24 次访谈,并采用基于扎根理论的内容分析法进行了分析。有三位独立的外部审核员对分析进行了监督。医院中的 ACP 是通过涉及案件的行为者的主动而存在的。专业人员认为彼此之间存在紧张领域;ACP 沟通的障碍。ACP 主要被认为是有价值的,因为它是一个为探索和反思创造时间的过程。

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