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专科医生和初级医生在照料姑息治疗患者时的合作经验与观点——一项定性研究

Specialist and Primary Physicians' Experiences and Perspectives of Collaboration While Caring for Palliative Patients-A Qualitative Study.

作者信息

Devik Siri Andreassen, Lersveen Gunhild Lein

机构信息

Centre for Care Research, Mid-Norway, Faculty of Nursing and Health Sciences, Nord University, 8026 Bodø, Norway.

Centre for Development of Institutional and Home Care Services in Trøndelag, 7650 Verdal, Norway.

出版信息

Healthcare (Basel). 2023 Aug 2;11(15):2188. doi: 10.3390/healthcare11152188.

Abstract

Increasing numbers of people living with chronic and life-limiting diseases are actualising a greater need for palliative care. Physicians are an important provider for identifying the need for palliation, and effective follow-up requires physician collaboration across different service levels. This study aimed to explore and describe how physicians in hospitals and municipalities experience their roles and interactions in the care of palliative patients. Pair interviews were performed with seven physicians working in hospitals, primary care and nursing homes in Mid-Norway. Systematic text condensation was used to analyse the data, resulting in three main themes: , and . The physicians' interactions with palliative patients appeared as a fragmented distribution of tasks rather than a real collaboration with shared responsibility. At both levels, the physicians seemed to assume withdrawn roles as a reaction to unclear and unspoken expectations and to avoid interfering with others' responsibilities. Moreover, their understanding of palliative care and which groups should be included varied. Realising a collaboration between physicians that is beneficial for both patients and physicians, greater openness and real arenas for discussion and decision-making support are required.

摘要

患有慢性和危及生命疾病的人数不断增加,这使得对姑息治疗的需求日益增长。医生是确定姑息治疗需求的重要提供者,而有效的后续跟进需要不同服务层面的医生协作。本研究旨在探讨和描述医院和市政当局的医生如何体验他们在姑息治疗患者护理中的角色和互动。对挪威中部医院、初级保健机构和养老院工作的七位医生进行了配对访谈。采用系统文本浓缩法分析数据,得出三个主要主题: 、 和 。医生与姑息治疗患者的互动表现为任务的分散分配,而非真正的共同承担责任的协作。在两个层面上,医生似乎都采取退缩的角色,以应对不明确和未言明的期望,并避免干扰他人的职责。此外,他们对姑息治疗的理解以及应纳入哪些群体的看法各不相同。要实现对患者和医生都有益的医生间协作,需要更大的开放性以及真正的讨论和决策支持平台。

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Integrating network theory into the study of integrated healthcare.将网络理论融入综合医疗保健研究。
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Health Care Provider Barriers to Patient Referral to Palliative Care.医疗保健提供者将患者转介至姑息治疗的障碍。
Am J Hosp Palliat Care. 2021 Sep;38(9):1112-1119. doi: 10.1177/1049909120973200. Epub 2020 Nov 23.

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