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一项关于通过参与代理来促进肺部疾病积极管理(FAMILIES)研究的可接受性试点研究。

An acceptability pilot of the facilitating active management in lung illness with engaged surrogates (FAMILIES) study.

作者信息

Ervin Jennifer N

出版信息

Medicine (Baltimore). 2020 Feb;99(9):e19272. doi: 10.1097/MD.0000000000019272.

Abstract

Approximately half of the surrogate decision makers of critically ill adults are at risk for negative emotional burden. Decision support and effective surrogate-clinician communication buffers against such experiences. The objective of this study is to evaluate the acceptability of a new surrogate-targeted educational tool that promotes engagement with clinicians and advocacy for 2 evidence-based practices in the provision of mechanical ventilation for acute respiratory failure: spontaneous awakening and breathing trials.A panel of 44 former patients and surrogates of a 20-bed medical intensive care unit in a large academic hospital responded to an online survey. Acceptability was measured on 3 dimensions: attitudes toward the content and delivery of information, objective knowledge translation, and subjective knowledge acquisition.More than 80% of participants found the tool to be easy to read, and over 90% felt that the tool provided actionable recommendations. A significant number of previously unsure participants were able to identify what spontaneous awakening and breathing trials are and when they occur, and 16% to 36% reported significant improvements in their subjective understanding of the target evidence-based practices, after being exposed to the educational tool.This line of work seeks to reduce surrogates' negative emotional burden while also promoting quality critical care. The educational tool provides a promising new way to promote surrogate-clinician communication, by increasing surrogates' knowledge about and encouraging advocacy for evidence-based practices in the provision of mechanical ventilation.

摘要

重症成年患者的替代决策者中约有一半面临负面情绪负担的风险。决策支持和有效的替代者与临床医生之间的沟通可缓冲此类经历。本研究的目的是评估一种新的针对替代者的教育工具的可接受性,该工具可促进替代者与临床医生的互动,并倡导在为急性呼吸衰竭患者提供机械通气时采用两种循证实践:自主觉醒和呼吸试验。一家大型学术医院的20张床位的医疗重症监护病房的44名 former 患者和替代者组成的小组对一项在线调查做出了回应。可接受性从三个维度进行衡量:对信息内容和传递方式的态度、客观知识转化以及主观知识获取。超过80%的参与者认为该工具易于阅读,超过90%的人认为该工具提供了可采取行动的建议。大量之前不确定的参与者能够识别什么是自主觉醒和呼吸试验以及它们何时发生,并且在接触该教育工具后,16%至36%的人报告称他们对目标循证实践的主观理解有了显著提高。这项工作旨在减轻替代者的负面情绪负担,同时促进高质量的重症护理。该教育工具通过增加替代者对提供机械通气时循证实践的了解并鼓励他们倡导这些实践,为促进替代者与临床医生之间的沟通提供了一种有前景的新方法。

原文中“former patients”这里翻译为“former”不太准确,可能是“之前的”意思,整体译文尽量忠实于原文,但部分表述可能因原文用词不太准确而稍显生硬。

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1
Communication expectations of critically ill patients and their families.重症患者及其家属的沟通期望。
J Emerg Crit Care Med. 2019 Sep;3. doi: 10.21037/jeccm.2019.09.02. Epub 2019 Sep 20.

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