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开发一种促进家长与医疗保健专业人员之间以家长为中心沟通的交流工具:一项质量改进项目。

The Development of a Communication Tool to Aid Parent-Centered Communication between Parents and Healthcare Professionals: A Quality Improvement Project.

作者信息

Marino Luise V, Collaḉo Nicole, Coyne Sophie, Leppan Megan, Ridgeway Steve, Bharucha Tara, Cochrane Colette, Fandinga Catarina, Palframan Karla, Rees Leanne, Osman Ahmed, Johnson Mark J, Hurley-Wallace Anna, Darlington Anne-Sophie E

机构信息

Paediatric Intensive Care, Southampton Children's Hospital, University Southampton Hospital NHS Foundation Trust, Southampton SO16 6YD, UK.

School of Health Sciences, Southampton University, Southampton SO17 1BJ, UK.

出版信息

Healthcare (Basel). 2023 Oct 10;11(20):2706. doi: 10.3390/healthcare11202706.

Abstract

Good communication is central to good healthcare. As a result of poor communication between parents and healthcare professionals (HCPs) in clinical settings, this study aimed to address this problem by developing a communication tool to empower parents and act as a prompt for HCPs to talk about the child's care and gather information at the point of admission to hospital about what is important to families, therefore supporting patient-centered communication. A design thinking process was used to develop a physical copy of Chloe's card and evaluate its use. Design thinking is a problem-solving approach, which uses an empathetic lens to integrate viewpoints of different stakeholders throughout the process of creating solutions. Design thinking involves five processes: (1) empathise-including a literature review and data synthesis, (2) define-by completing semi-structured interviews with parents about their experience of communication and HCPs perceptions of parent's experience of communication, (3) ideate-iterate the design of Chloe's card with parents and HCPs, (4) prototype-develop the design of Chloe's card, and (5) test-pilot test in clinical practice. Results from this initial study suggest that a small hand-held card, with emoticons and a place to write concerns, was acceptable to parents and feasible to use in clinical practice. Parents do not always feel heard by HCPs and a tool such as Chloe's card may help facilitate sharing of information about matters important to them and their child. However, some HCPs felt the need for a communication tool undermined their clinical skills. Feedback from HCP participants suggests that the idea of Chloe's card was acceptable and perceived as potentially being useful in clinical practice. Further work is required, as part of a larger study, to further refine this communication tool, identify those parents who would benefit most from Chloe's card, as well as to further refine the HCP process prior to implementing it into clinical settings. It was noted future iterations would benefit from a digital version linked with a child's electronic record, as well as multi-language versions and information for parents.

摘要

良好的沟通是优质医疗保健的核心。由于临床环境中家长与医护人员(HCPs)之间沟通不畅,本研究旨在通过开发一种沟通工具来解决这一问题,该工具既能增强家长的能力,又能促使医护人员在孩子入院时谈论其护理情况,并收集对家庭来说重要的信息,从而支持以患者为中心的沟通。采用设计思维流程来开发克洛伊卡片的实体版本并评估其使用情况。设计思维是一种解决问题的方法,它在整个解决方案创建过程中运用同理心视角来整合不同利益相关者的观点。设计思维包括五个流程:(1)共情——包括文献综述和数据综合;(2)定义——通过与家长进行半结构化访谈,了解他们的沟通经历以及医护人员对家长沟通经历的看法;(3)构思——与家长和医护人员反复迭代克洛伊卡片的设计;(4)原型制作——开发克洛伊卡片的设计;(5)测试——在临床实践中进行试点测试。这项初步研究的结果表明,一张带有表情符号和书写担忧之处的小型手持卡片,家长们可以接受,并且在临床实践中使用可行。家长们并不总是觉得医护人员倾听了他们的意见,像克洛伊卡片这样的工具可能有助于促进分享对他们及其孩子来说重要的事情的信息。然而,一些医护人员认为沟通工具的存在削弱了他们的临床技能。医护人员参与者的反馈表明,克洛伊卡片的想法是可以接受的,并且被认为在临床实践中可能有用。作为一项更大规模研究的一部分,还需要进一步开展工作,以进一步完善这种沟通工具,确定哪些家长会从克洛伊卡片中受益最大,以及在将其应用于临床环境之前进一步完善医护人员的流程。值得注意的是,未来的迭代版本将受益于与孩子电子记录相关联的数字版本、多语言版本以及为家长提供的信息。

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