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利益相关者对新冠疫情对临床护理和决策影响的认知差异。

Differences in Stakeholders' Perception of the Impact of COVID-19 on Clinical Care and Decision-Making.

作者信息

Haier Joerg, Beller Johannes, Adorjan Kristina, Bleich Stefan, de Greck Moritz, Griesinger Frank, Heppt Markus V, Hurlemann René, Mees Soeren Torge, Philipsen Alexandra, Rohde Gernot, Schilling Georgia, Trautmann Karolin, Combs Stephanie E, Geyer Siegfried, Schaefers Juergen

机构信息

Comprehensive Cancer Center Hannover, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.

Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany.

出版信息

Cancers (Basel). 2022 Sep 2;14(17):4317. doi: 10.3390/cancers14174317.

Abstract

Background: Pandemics are related to changes in clinical management. Factors that are associated with individual perceptions of related risks and decision-making processes focused on prevention and vaccination, but perceptions of other healthcare consequences are less investigated. Different perceptions of patients, nurses, and physicians on consequences regarding clinical management, decisional criteria, and burden were compared. Study Design: Cross-sectional OnCoVID questionnaire studies. Methods: Data that involved 1231 patients, physicians, and nurses from 11 German institutions that were actively involved in clinical treatment or decision-making in oncology or psychiatry were collected. Multivariate statistical approaches were used to analyze the stakeholder comparisons. Results: A total of 29.2% of professionals reported extensive changes in workload. Professionals in psychiatry returned severe impact of pandemic on all major aspects of their clinical care, but less changes were reported in oncology (p < 0.001). Both patient groups reported much lower recognition of treatment modifications and consequences for their own care. Decisional and pandemic burden was intensively attributed from professionals towards patients, but less in the opposite direction. Conclusions: All of the groups share concerns about the impact of the COVID-19 pandemic on healthcare management and clinical processes, but to very different extent. The perception of changes is dissociated in projection towards other stakeholders. Specific awareness should avoid the dissociated impact perception between patients and professionals potentially resulting in impaired shared decision-making.

摘要

背景

大流行与临床管理的变化相关。一些因素与个人对相关风险的认知以及侧重于预防和疫苗接种的决策过程有关,但对其他医疗后果的认知研究较少。比较了患者、护士和医生对临床管理后果、决策标准和负担的不同认知。

研究设计

横断面OnCoVID问卷调查研究。

方法

收集了来自11家德国机构的1231名患者、医生和护士的数据,这些机构积极参与肿瘤学或精神病学的临床治疗或决策。采用多变量统计方法分析利益相关者的比较情况。

结果

共有29.2%的专业人员报告工作量有大幅变化。精神病学专业人员报告大流行对其临床护理的所有主要方面都有严重影响,但肿瘤学领域报告的变化较少(p < 0.001)。两组患者对治疗调整及其自身护理后果的认知都低得多。决策负担和大流行负担主要由专业人员归咎于患者,反之则较少。

结论

所有群体都对COVID-19大流行对医疗管理和临床过程的影响表示担忧,但程度差异很大。对变化的认知在投射到其他利益相关者时是脱节的。应提高特定意识,避免患者和专业人员之间可能导致共同决策受损的脱节影响认知。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e0e/9454870/1ea980eeb5c8/cancers-14-04317-g001.jpg

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