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运用共同设计制定一项干预措施,以改善心力衰竭轨迹和临终关怀的沟通。

Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care.

机构信息

Department of Social and Welfare Studies (ISV), Faculty of Health Sciences, Linköping University, 581 83, Linköping, Sweden.

Department of Medical and Health Sciences, Division of nursing, Faculty of Health Sciences, Linköping University, Linköping, Sweden.

出版信息

BMC Palliat Care. 2018 Jun 11;17(1):85. doi: 10.1186/s12904-018-0340-2.

Abstract

BACKGROUND

The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention.

METHODS

Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy.

RESULTS

Two communication tools were designed and evaluated; 1) a Question Prompt List (QPL) for patients and family members and 2) a communication course for professionals which was web -based with one face-to-face training day with simulation. Data on feasibility was collected with questionnaires that were developed for this study, from the 13 participants who completed the course (all nurses). They reported improved knowledge, confidence and skills to discuss the HF trajectory and end-of-life care. The QPL was evaluated to be a useful tool in communication with patients and family members.

CONCLUSIONS

In a co-design process, future users identified the need for a QPL and a communication course. These communication tools can be used as a dual intervention to improve communication about the HF trajectory and end-of-life care. The QPL can help patients and families to ask questions about the HF trajectory and end-of-life care. The communication course can prepare the professionals to be knowledgeable, confident and skilled to discuss the questions in the QPL. Before the tools are ready for implementation in clinical practice, further studies testing the feasibility of the intervention are needed, including also patients and their families.

摘要

背景

本文旨在描述一种干预措施的开发过程,该干预措施旨在改善心力衰竭(HF)轨迹和临终关怀的沟通。我们还提供了数据,首次深入了解了干预措施的特定可行性领域。

方法

采用共同设计,患者、家庭成员和医疗保健专业人员是干预措施设计过程中的建设性参与者。在两个领域测试了干预措施的可行性;可接受性和有限的疗效。

结果

设计并评估了两种沟通工具;1)患者和家庭成员的问题提示清单(QPL),2)专业人员的沟通课程,该课程是基于网络的,有一天面对面的培训和模拟。使用为这项研究开发的问卷收集了关于可行性的数据,共有 13 名完成课程的参与者(均为护士)。他们报告说,他们在讨论 HF 轨迹和临终关怀方面的知识、信心和技能有所提高。QPL 被评估为与患者和家庭成员进行沟通的有用工具。

结论

在共同设计过程中,未来的使用者确定需要 QPL 和沟通课程。这些沟通工具可以用作双重干预措施,以改善 HF 轨迹和临终关怀的沟通。QPL 可以帮助患者和家属询问 HF 轨迹和临终关怀的问题。沟通课程可以使专业人员具备知识、信心和技能,以讨论 QPL 中的问题。在这些工具准备好应用于临床实践之前,需要进一步研究测试干预措施的可行性,包括患者及其家属。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c61/5996457/e602bf0eee9d/12904_2018_340_Fig1_HTML.jpg

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