1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
2 Interdepartmental Division of Critical Care and.
Am J Respir Crit Care Med. 2018 Aug 1;198(3):310-319. doi: 10.1164/rccm.201710-2032CI.
The call for meaningful patient and family engagement in health care and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, we review the rationale and the current state of patient and family engagement in patient care and research in the ICU. We identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. We also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, we provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
呼吁在医疗保健和研究中让患者和家属有意义地参与进来的呼声越来越高。医疗机构和研究资助机构越来越鼓励临床医生和研究人员积极与患者及其家属合作，以推进临床护理和研究。参与度越来越受到医疗保健组织的要求，并成为研究资金的前提条件。在本文中，我们回顾了在 ICU 中患者护理和研究中患者和家属参与的基本原理和现状。我们确定了通过促进患者和家属更多地参与护理提供以及支持他们参与共同决策来加强患者护理参与度的机会。我们还确定了与患者参与意愿、参与障碍、参与者风险和参与者期望相关的挑战。为了推进参与度，临床医生和研究人员可以在 ICU 环境中发展参与背后的科学，并展示其对患者和过程相关结果的影响。此外，我们还提供了有关如何参与的实用指南，突出了成功参与策略的特点，并确定了未来研究的领域。目前，在 ICU 护理和研究的整个连续体中增强参与度仍然存在巨大的机会。
