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团体概念图构想了高质量的长期儿科重症监护病房患者和家庭的护理。

Group Concept Mapping Conceptualizes High-Quality Care for Long-Stay Pediatric Intensive Care Unit Patients and Families.

机构信息

Division of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, IN.

John J. Lynch, MD Center for Ethics, MedStar Washington Hospital Center, Washington, DC.

出版信息

J Pediatr. 2023 Jan;252:48-55.e1. doi: 10.1016/j.jpeds.2022.08.007. Epub 2022 Aug 13.

Abstract

OBJECTIVE

To describe and conceptualize high-quality care for long-stay pediatric intensive care unit (PICU) patients using group concept mapping (GCM).

STUDY DESIGN

We convened an expert panel to elucidate domains of high-quality care for this growing patient population for which transitory care models fail to meet their needs. Thirty-one healthcare professionals and 7 parents of patients with previous prolonged PICU hospitalizations comprised a diverse, interprofessional multidisciplinary panel. Participants completed the prompt "For PICU patients and families experiencing prolonged lengths of stay, high quality care from the medical team includes ______", with unlimited free text responses. Responses were synthesized into individual statements, then panelists sorted them by idea similarity and rated them by perceived importance. Statement analysis using GCM software through GroupWisdom generated nonoverlapping clusters representing domains of high-quality care.

RESULTS

Participants submitted 265 prompt responses representing 313 unique ideas, resulting in 78 final statements for sorting and rating. The resultant cluster map best representing the data contained 8 domains: (1) Family-Centered Care and Shared Decision Making, (2) Humanizing the Patient, (3) Clinician Supports and Resources, (4) Multidisciplinary Coordination of Care, (5) Family Well-Being, (6) Anticipatory Guidance and Care Planning, (7) Communication, and (8) Continuity of Care.

CONCLUSIONS

GCM empowered a panel of healthcare professionals and parents to explicitly describe and conceptualize high-quality care for patients and families experiencing prolonged PICU stays. This information will aid the effort to address shortcomings of transitory PICU care models.

摘要

目的

使用群体概念映射(GCM)描述和概念化长期留院儿科重症监护病房(PICU)患者的高质量护理。

研究设计

我们召集了一个专家小组,阐明了这种不断增长的患者群体的高质量护理领域,对于这些患者,过渡性护理模式未能满足他们的需求。31 名医疗保健专业人员和 7 名曾有过长时间 PICU 住院经历的患者的父母组成了一个多元化、跨专业的多学科小组。参与者完成了“对于经历长时间 PICU 住院的 PICU 患者和家庭,医疗团队的高质量护理包括_____”的提示,可进行不限次数的自由文本回复。回复被综合成单独的陈述,然后小组成员根据想法的相似性对其进行分类,并根据感知的重要性对其进行评分。使用 GroupWisdom 的 GCM 软件对陈述进行分析,生成了不重叠的聚类,代表高质量护理的领域。

结果

参与者提交了 265 个提示回复,代表了 313 个独特的想法,最终产生了 78 个用于分类和评分的最终陈述。最能代表数据的聚类图包含 8 个领域:(1)以家庭为中心的护理和共同决策,(2)人性化患者,(3)临床医生的支持和资源,(4)多学科协调护理,(5)家庭福祉,(6)预期指导和护理计划,(7)沟通,和(8)护理连续性。

结论

GCM 使医疗保健专业人员和家长小组能够明确描述和概念化长期留院 PICU 患者和家庭的高质量护理。这些信息将有助于解决过渡性 PICU 护理模式的不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a3/9772094/fbd532316ff0/nihms-1833781-f0001.jpg

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