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包括痴呆症患者在内的医疗问诊中的三元沟通:一项范围综述

Triadic Communication in Medical Encounters Including Individuals With Dementia: A Scoping Review.

作者信息

Wollney Easton N, Armstrong Melissa J, Hampton Chelsea N, McCall-Junkin Patti, Bedenfield Noheli, Fisher Carla L, Bylund Carma L

机构信息

Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL.

Department of Neurology, University of Florida College of Medicine, Gainesville, FL.

出版信息

Alzheimer Dis Assoc Disord. 2024;38(2):213-225. doi: 10.1097/WAD.0000000000000626. Epub 2024 May 30.

DOI:10.1097/WAD.0000000000000626
PMID:38812448
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11977097/
Abstract

PURPOSE

The overall goal of this review was to identify what is known about triadic (clinician-patient-caregiver) communication in mild cognitive impairment (MCI) and dementia care settings throughout the care continuum.

METHODS

Using a structured search, we conducted a systematic scoping review of relevant published journal articles across 5 databases. Study titles/abstracts and selected full-text articles were screened by 2 investigators in Covidence systematic review software. Articles were excluded if they were not about clinical communication, focused only on caregiver-patient communication or communication in residential care, were interventional, lacked empirical data, or were not in English. Extracted data were documented using Google Forms.

RESULTS

The study team screened 3426 article titles and abstracts and 112 full-text articles. Forty-four articles were included in the final review. Results were categorized by 3 communication scenarios: diagnostic communication (n=22), general communication (n=16), and advanced care planning communication (n=6).

CONCLUSIONS AND RELEVANCE

Across the included articles, the conceptualization and assessment of communication lacked homogeneity. Future directions include addressing these research gaps, establishing recommendations for clinicians to effectively communicate with individuals with dementia and caregivers, and creating and testing communication skills trainings for caregivers/family members, clinicians, and/or individuals with dementia to facilitate effective communication.

摘要

目的

本综述的总体目标是确定在整个护理过程中,关于轻度认知障碍(MCI)和痴呆症护理环境中的三元组(临床医生 - 患者 - 照顾者)沟通的已知情况。

方法

通过结构化检索,我们对5个数据库中已发表的相关期刊文章进行了系统的范围综述。研究标题/摘要和选定的全文文章由两名研究人员在Covidence系统综述软件中进行筛选。如果文章不是关于临床沟通、仅关注照顾者 - 患者沟通或机构护理中的沟通、是干预性的、缺乏实证数据或不是英文的,则将其排除。提取的数据使用谷歌表格进行记录。

结果

研究团队筛选了3426篇文章标题和摘要以及112篇全文文章。最终综述纳入了44篇文章。结果按3种沟通场景分类:诊断沟通(n = 22)、一般沟通(n = 16)和高级护理计划沟通(n = 6)。

结论与意义

在所纳入的文章中,沟通的概念化和评估缺乏同质性。未来的方向包括解决这些研究差距,为临床医生制定与痴呆症患者及照顾者有效沟通的建议,以及为照顾者/家庭成员、临床医生和/或痴呆症患者创建并测试沟通技能培训,以促进有效沟通。