Department of Critical Care Medicine, Alberta Health Services and University of Calgary.
Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary.
Curr Opin Crit Care. 2019 Oct;25(5):505-510. doi: 10.1097/MCC.0000000000000643.
Patient and family partnership in critical care medicine research and clinical care is essential to achieve patient and family-centered care. Although there is an increasing interest in patient and family engagement, research is lacking to direct clinicians and researchers on how to provide opportunities for meaningful engagement. We review the recent literature and provide examples from our own experiences to guide all parties in this important and emerging area.
Though the literature is relatively nascent, studies suggest that there is a desire to engage patients and families in critical care medicine research and clinical care, however, uncertainty exists on how to achieve this goal. Engagement exists on a spectrum from presence to shared decision-making and direct contributions to care; most engagement in critical care medicine involves participation in research and presence at the bedside. Expectation management is essential for meaningful engagement and true partnership. Challenges to patient and family engagement exist, including determining appropriate compensation, aligning engagement with needs and skills, and recruitment, training and retention. These challenges can be mitigated with thoughtful planning and management.
Patient and family engagement in critical care medicine is an emerging field that requires further study to support definitive conclusions. Until then, it is important to match interested patients and family members with appropriate opportunities and provide training and support to ensure meaningful engagement.
目的综述：在重症医学研究和临床护理中，患者和家属的合作至关重要，这是实现以患者和家属为中心的护理的关键。尽管人们对患者和家属的参与越来越感兴趣，但缺乏指导临床医生和研究人员如何提供有意义的参与机会的研究。我们回顾了最近的文献，并从我们自己的经验中提供了一些示例，以指导所有各方在这一重要且新兴的领域开展工作。
最近发现：尽管文献相对较新，但研究表明，人们希望让患者和家属参与重症医学的研究和临床护理，但如何实现这一目标仍存在不确定性。参与度存在于从存在到共同决策和直接参与护理的范围内；重症医学中的大多数参与都涉及参与研究和在床边参与。期望管理对于有意义的参与和真正的合作至关重要。患者和家属参与存在挑战，包括确定适当的补偿、使参与与需求和技能保持一致，以及招募、培训和保留。通过深思熟虑的规划和管理，可以减轻这些挑战。
总结：重症医学中的患者和家属参与是一个新兴领域，需要进一步研究来支持明确的结论。在那之前，重要的是要将有兴趣的患者和家属与适当的机会相匹配，并提供培训和支持，以确保有意义的参与。
