居家安宁疗护探访中的共同决策：一项定性研究。
Shared Decision Making in Home Hospice Nursing Visits: A Qualitative Study.
机构信息
Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.
Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.
出版信息
J Pain Symptom Manage. 2018 Mar;55(3):922-929. doi: 10.1016/j.jpainsymman.2017.10.022. Epub 2017 Nov 9.
CONTEXT
Shared decisions between health care providers and patients and families are replacing the traditional physician-driven plans of care. Hospice philosophy recognizes the patient and family as a unit of care and embraces their role in decision making.
OBJECTIVE
The goal of this study was to evaluate the shared decisions between hospice nurses and patients and family members.
METHODS
A secondary analysis of audio recordings of 65 home hospice nurse visits from 65 home hospice nurse visits in 11 different U.S. hospice programs.
RESULTS
To varying degrees, hospice nurses used all the recommended elements of shared decision making during home visits with patients and families; however, not all elements were used in every visit. The most commonly used element was defining a problem, and the least used element was the assessment of patient and family understanding.
CONCLUSIONS
Hospice staff can benefit from a more purposeful shared decision-making process and a greater focus on assessment of patient and family understanding and ability to implement plans of care.
背景
医疗保健提供者与患者和家属之间的共同决策正在取代传统的医生主导的护理计划。临终关怀理念将患者及其家属视为一个护理单元，并接受他们在决策中的角色。
目的
本研究旨在评估临终关怀护士与患者和家属之间的共同决策。
方法
对 11 个不同美国临终关怀项目的 65 名居家临终关怀护士的 65 次家访的音频记录进行二次分析。
结果
在不同程度上，临终关怀护士在与患者和家属的家访中使用了所有推荐的共同决策要素；然而，并非所有要素都在每次访问中使用。最常用的要素是定义问题，而使用最少的要素是评估患者和家属的理解。
结论
临终关怀工作人员可以从更有针对性的共同决策过程和更注重评估患者和家属的理解以及实施护理计划的能力中受益。
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