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卒中护理中的患者伙伴关系:一项范围综述

Patient Partnership in Stroke Care: A Scoping Review.

作者信息

Bux Hussain, Zurel Furkan, Rashid Zakaria, Sani Immanuel

机构信息

Medical Education, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR.

General Surgery, Salford Royal NHS Foundation Trust, Manchester, GBR.

出版信息

Cureus. 2025 Jul 7;17(7):e87446. doi: 10.7759/cureus.87446. eCollection 2025 Jul.

Abstract

Patient partnership is increasingly recognised as a core component of high-quality healthcare. This review aims to explore how patient partnership is implemented across the stroke pathway, where recovery trajectories are complex and multidimensional. It will also show how medical education can shift student learning from a transactional process to one of partnership and collaboration. A literature search was conducted across Cochrane Library, Embase, and PubMed, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies were screened by title, abstract, and full text against eligibility criteria. Eleven articles were included in the review. Each article underwent quality appraisal using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis was used, mapping findings onto three key stages of the Stroke RightCare Pathway: hyperacute, the stroke unit and early supported discharge, and long-term rehabilitation. This review found that the role of the patient and clinician has changed in modern-day healthcare from paternalistic to one that aims to actively bring clinicians and patients together to form a collaborative partnership. Tailoring this partnership in each stage of stroke care is vital. In the hyperacute stroke setting, clinician-led decisions were found to be most beneficial for the patient due to the short time window to initiate treatment. During the acute phase, educating patients to understand their condition can allow for meaningful and collaborative goal-setting to take place, which has demonstrated improved patient outcomes. In medical education, introducing patient partnership early in a student's training is essential for creating a lasting impact on healthcare. Patient partnership must be tailored across the stroke pathway, and embedding these principles in medical education is important in shaping future clinicians' attitudes and practices. Future research should explore formal patient partnership training strategies for both students and clinicians. It should also assess whether clinicians find this approach appropriate across different medical conditions and clinical settings.

摘要

患者伙伴关系日益被视为高质量医疗保健的核心组成部分。本综述旨在探讨在中风治疗过程中如何实施患者伙伴关系,因为中风的康复轨迹复杂且具有多维度性。它还将展示医学教育如何将学生的学习从一种交易性过程转变为伙伴关系与协作的过程。根据系统评价和Meta分析扩展的范围综述的首选报告项目(PRISMA-ScR)指南,在Cochrane图书馆、Embase和PubMed上进行了文献检索。根据纳入标准,通过标题、摘要和全文对研究进行筛选。该综述纳入了11篇文章。每篇文章都使用批判性评估技能计划(CASP)工具进行了质量评估。采用主题综合法,将研究结果映射到中风正确治疗途径的三个关键阶段:超急性期、中风单元和早期支持出院以及长期康复。本综述发现,在现代医疗保健中,患者和临床医生的角色已从家长式转变为旨在积极促使临床医生和患者走到一起形成合作伙伴关系的角色。在中风护理的每个阶段调整这种伙伴关系至关重要。在超急性中风情况下,由于启动治疗的时间窗口较短,发现由临床医生主导的决策对患者最为有益。在急性期,教育患者了解自己的病情可以促进有意义的合作目标设定,这已证明能改善患者的治疗结果。在医学教育中,在学生培训早期引入患者伙伴关系对于对医疗保健产生持久影响至关重要。必须在整个中风治疗过程中调整患者伙伴关系,将这些原则融入医学教育对于塑造未来临床医生的态度和实践很重要。未来的研究应探索针对学生和临床医生的正式患者伙伴关系培训策略。还应评估临床医生是否认为这种方法适用于不同的医疗状况和临床环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7257/12327550/79e83ed57898/cureus-0017-00000087446-i01.jpg

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