外科病房查房核心参与者的经验与需求:定性探索性研究
Experiences and Needs of Core Participants in Surgical Ward Rounds: Qualitative Exploratory Study.
作者信息
Poulsen Helle, Clemensen Jane, Ammentorp Jette, Kofoed Poul-Erik, Wolderslund Maiken
机构信息
Department of Surgery, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, Kolding, DK-6000, Denmark, 45 76362665.
Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
出版信息
J Particip Med. 2025 May 15;17:e69578. doi: 10.2196/69578.
BACKGROUND
Surgical ward rounds (SWRs) are typically led by doctors, with limited involvement from key participants, including patients, family members, and bedside nurses. Despite the potential benefits of a more collaborative and person-centered approach, efforts to engage these stakeholders remain rare.
OBJECTIVE
This qualitative exploratory study aims to examine the experiences and needs of doctors, nurses, patients, and their relatives during SWRs as part of a participatory design process.
METHODS
Data were collected through ethnographic field studies, focus groups with the health care providers, patients, and relatives, and dyadic interviews conducted as part of home visits to patients and their partners after discharge. Field notes and interview data were analyzed using systematic text condensation.
RESULTS
Lack of organization, traditional roles, and cultural norms compromised the quality, efficiency, and user experience of SWRs in multiple ways. SWRs were routine-driven, treatment-focused, and received lower priority than surgical tasks. Unpredictability resulted in unprepared participants and limited access for nurses, patients, and relatives to partake.
CONCLUSIONS
The study identified a gap between the organizational and cultural frameworks governing the SWRs and the experiences and needs of key participants. Digital technologies were perceived as a potential solution to address some of these challenges.
背景
外科病房查房(SWRs)通常由医生主导,关键参与者(包括患者、家属和床边护士)的参与有限。尽管采用更具协作性和以患者为中心的方法可能带来益处,但让这些利益相关者参与的努力仍然很少见。
目的
这项定性探索性研究旨在作为参与式设计过程的一部分,考察外科病房查房期间医生、护士、患者及其亲属的经历和需求。
方法
通过人种志实地研究、与医疗服务提供者、患者及其亲属进行的焦点小组讨论,以及在患者出院后对其及其伴侣进行家访时进行的二元访谈收集数据。使用系统文本浓缩法分析实地记录和访谈数据。
结果
缺乏组织、传统角色和文化规范在多个方面损害了外科病房查房的质量、效率和用户体验。外科病房查房以常规为导向、以治疗为重点,且比手术任务的优先级低。不可预测性导致参与者准备不足,护士、患者和亲属参与的机会有限。
结论
该研究发现了管理外科病房查房的组织和文化框架与关键参与者的经历和需求之间的差距。数字技术被视为应对其中一些挑战的潜在解决方案。