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持续深度镇静直至死亡的控制措施:对医生观点的框架分析。

Control Measures for Continuous Deep Sedation Until Death: A Framing Analysis of the Views of Physicians.

机构信息

End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.

Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.

出版信息

Qual Health Res. 2021 Nov;31(13):2390-2402. doi: 10.1177/10497323211037648. Epub 2021 Oct 7.

Abstract

Physicians have been subject to increasing external control to improve their medical practice, and scholars have theorized extensively about their opposition to such control. However, little empirical attention has been paid to the views and reasoning that lie behind this opposition. An in-depth understanding is necessary for enhancing the effectiveness and efficiency of external controls, and continuous deep sedation until death (CDS) is an interesting case in this regard. This study aims to explore how physicians frame control measures for CDS. We conducted 47 semi-structured interviews with Belgian physicians in 2019. A qualitative framing analysis was performed to analyze their views and reasoning. This study reveals that physicians approach CDS practice and control measures with different emphases. Controlling by mechanisms of professional self-regulation and state governance are put forward as appropriate means to improve CDS practice. Policymakers should take into consideration physicians' frames to develop sound control measures.

摘要

医生们一直受到越来越多的外部控制,以改善他们的医疗实践,学者们也广泛地对他们对这种控制的抵制进行了理论研究。然而,很少有实证研究关注这种抵制背后的观点和推理。深入了解这一点对于提高外部控制的有效性和效率是必要的,持续深度镇静直至死亡(CDS)在这方面是一个有趣的案例。本研究旨在探讨医生如何构建 CDS 的控制措施。我们在 2019 年对比利时的医生进行了 47 次半结构化访谈。采用定性框架分析对他们的观点和推理进行了分析。本研究表明,医生对 CDS 实践和控制措施的侧重点不同。通过专业自我监管机制和国家治理来控制被提出作为改善 CDS 实践的适当手段。政策制定者应考虑到医生的框架来制定合理的控制措施。

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