医疗保健提供者对现实生活中产科急症视频辅助讨论的看法和期望：来自丹麦的定性研究。
Healthcare providers' perceptions and expectations of video-assisted debriefing of real-life obstetrical emergencies: a qualitative study from Denmark.
机构信息
Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
出版信息
BMJ Open. 2023 Mar 14;13(3):e062950. doi: 10.1136/bmjopen-2022-062950.
OBJECTIVES
Video-assisted debriefing (VAD) of real-life obstetrical emergencies provides an opportunity to improve quality of care, but is rarely used in clinical practice. A barrier for implementation is the expected mental reservations among healthcare providers. The aim of this study was to explore healthcare providers' perceptions and expectations of VAD of real-life events.
SETTING
Participants were recruited from two Labour and Delivery Units in Denmark. In both units, VAD of real-life obstetrical emergencies had never been conducted.
PARTICIPANTS
22 healthcare providers (10 physicians, 9 midwives and 3 nursing assistants). During the study period (August-October 2021), semi-structured, individual interviews were conducted. Interviews were analysed using thematic analysis.
PRIMARY AND SECONDARY OUTCOME MEASURES
A qualitative description of healthcare providers' perceptions and expectations of VAD of real-life events.
RESULTS
Three major themes were identified: (1) All participants expected VAD to provide an opportunity for learning and improving patient care. All participants expected the video to provide a 'bigger picture', by showing 'what was actually done' instead of 'what we believed was done'. (2) The primary concern for all participants was the risk of being exposed as less competent. Participants were concerned that being confronted with every minor detail of their clinical practice would enhance their self-criticalness. (3) Participants emphasised the importance of organisational support from management. In addition, creating a safe environment for VAD, for example, by using only expert debriefers was considered an essential precondition for successful implementation.
CONCLUSIONS
The risk of being exposed as less competent was a barrier towards VAD of real-life events. However, the majority found the educational benefits to outweigh the risk of being exposed.
目的
对真实产科急症进行视频辅助讨论（VAD）为改善医疗质量提供了机会，但在临床实践中很少使用。实施的一个障碍是医疗保健提供者的预期心理保留。本研究的目的是探讨医疗保健提供者对真实事件 VAD 的看法和期望。
背景
参与者是从丹麦的两个分娩病房招募的。在这两个病房中，从未进行过真实产科急症的 VAD。
参与者
22 名医疗保健提供者（10 名医生、9 名助产士和 3 名护理助理）。在研究期间（2021 年 8 月至 10 月），进行了半结构化的个人访谈。使用主题分析对访谈进行分析。
主要和次要结果
描述医疗保健提供者对真实事件 VAD 的看法和期望的定性。
结果
确定了三个主要主题：（1）所有参与者都期望 VAD 提供学习和改善患者护理的机会。所有参与者都期望视频提供一个“大局”，通过展示“实际做了什么”而不是“我们认为做了什么”。（2）所有参与者的主要关注点是暴露自己能力不足的风险。参与者担心被暴露在他们临床实践的每一个小细节中，会增强他们的自我批评。（3）参与者强调了管理层提供组织支持的重要性。此外，为 VAD 创建一个安全的环境，例如仅使用专家讨论者，被认为是成功实施的必要前提。
结论
暴露自己能力不足的风险是对真实事件 VAD 的障碍。然而，大多数人认为教育收益超过了被暴露的风险。
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