Smyth James, Dollard Joanne, Visvanathan Renuka, Archibald Mandy
Adelaide Medical School, The University of Adelaide, Adelaide, AUS.
College of Nursing, University of Manitoba, Winnipeg, CAN.
Cureus. 2024 Dec 13;16(12):e75670. doi: 10.7759/cureus.75670. eCollection 2024 Dec.
Background The proportion of older people in the general population is rising. Accompanying this rise is an increased prevalence of frailty. Frailty is a syndrome of increased vulnerability to stressors due to decreased physiological reserve and is linked to increased health services use. Frailty assessment provides a comprehensive insight into an older person's health status but is not regularly performed in emergency departments (EDs) worldwide. Understanding emergency physicians' (EPs) perspectives on frailty could assist in facilitating the implementation of frailty assessments in the ED. However, little is known about EP perceptions of frailty. Objectives The aim of this study was to explore perspectives on frailty among EPs. Design An exploratory qualitative descriptive study was conducted. EPs' perspectives on frailty were explored in semi-structured interviews, including questions on the meaning of frailty, its detection, management, and potential to improve the care of frail ED patients. Interviews were recorded and transcribed. Setting Central Adelaide Local Health Network, which has two EDs in Adelaide, South Australia. Participants Sixteen EPs were interviewed. Eleven (69%) were male EPs and 10 (63%) were practicing as EPs for 4 years or less. Measurements We analyzed interview transcripts by inductive thematic analysis. We generated, iteratively revised, and applied a coding framework, enabling progression to the formulation of themes. Results We developed three themes. Theme 1: EPs did not perceive frailty as a priority of care due to their focus on acuity, and lack of knowledge, time, and resources. Theme 2: EPs referred to detecting and managing frailty indirectly rather than formally. Theme 3: EPs saw a beneficial role in frailty recognition and management in the future. Conclusions EPs did not perceive frailty as a priority of care. However, they had a positive view on progressing with increased frailty awareness and holistic management in EM, for patient and health system benefits.
老年人口在总人口中的比例正在上升。伴随着这一增长，衰弱的患病率也在增加。衰弱是一种由于生理储备减少而导致对应激源易感性增加的综合征，并且与卫生服务使用的增加有关。衰弱评估能全面洞察老年人的健康状况，但在全球范围内的急诊科（ED）中并未定期开展。了解急诊医生（EP）对衰弱的看法有助于推动在急诊科实施衰弱评估。然而，对于急诊医生对衰弱的认知却知之甚少。
本研究的目的是探讨急诊医生对衰弱的看法。
进行了一项探索性定性描述性研究。通过半结构化访谈探讨急诊医生对衰弱的看法，包括关于衰弱的含义、检测、管理以及改善衰弱急诊患者护理的可能性等问题。访谈进行了录音和转录。
南澳大利亚阿德莱德中央阿德莱德地方卫生网络，该网络在阿德莱德有两个急诊科。
对16名急诊医生进行了访谈。其中11名（69%）为男性急诊医生，10名（63%）从事急诊医生工作4年或以下。
我们通过归纳主题分析对访谈转录本进行了分析。我们生成、反复修订并应用了一个编码框架，从而能够逐步形成主题。
我们形成了三个主题。主题1：由于急诊医生关注急症、缺乏知识、时间和资源，他们不认为衰弱是护理的优先事项。主题2：急诊医生提到间接而非正式地检测和管理衰弱。主题3：急诊医生认为衰弱识别和管理在未来将发挥有益作用。
急诊医生不认为衰弱是护理的优先事项。然而，他们对于在急诊医学中提高对衰弱的认识并进行整体管理持积极态度，这对患者和卫生系统都有益处。
