都是 "囊中物 "吗?ImproveCareNow 网络中关于小儿 IBD 造口手术的多学科观点

JPGN reports Pub Date : 2024-02-12 DOI:10.1002/jpr3.12044
J. David, Jennifer L. Dotson, Laura Mackner
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引用次数: 0

摘要

小儿炎症性肠病(IBD)是一种慢性疾病,有多种治疗方法,包括造口手术。对于多学科医疗保健专业人员(HCPs)来说,造口相关的医疗决策(MDM)非常复杂。本研究旨在了解美国全国多学科医护人员对小儿 IBD 造口手术的看法。这项横断面 REDCap 调查招募了来自 ImproveCareNow (ICN) 学习健康系统的小儿 IBD 医护人员。调查收集了以下方面的数据:(1)人口统计学;(2)参与者对患者/家属造口观念的看法;(3)参与者自身对造口的看法;以及(4)参与者对造口手术中多学科协作的看法。参与者(n = 69,分布在美国 30 个 ICN 站点)中,84% 为白人,62% 为女性,54% 为消化科医生。在反思患者/家属的看法时,参与者认可大多数(86%)将造口视为 "失败"、各种社会心理问题(例如,97%认可身体形象问题),以及大多数(81%)对造口有中度到严重的成见。在反思他们自己的看法时,近一半(44%)的人表示对造口有一些至中等程度的成见,并认为当家人有负面看法时,讨论造口是困难的(88%)。超过半数(54%)的患者表示目前在小儿肠道疾病手术方面接受多学科治疗。与小儿 IBD 造口手术相关的 MDM 给 HCPs 带来了细微的临床复杂性。这项工作强调了对多学科护理的兴趣、与造口相关的显著社会心理需求以及与造口相关的耻辱感。未来的工作应开发系统的多学科小儿 IBD 造口护理方法,加强社会心理支持,并评估系统护理如何影响社会心理和医疗保健利用结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is it “all in the bag?” Multidisciplinary perspectives on ostomy surgery in pediatric IBD across the ImproveCareNow network
Pediatric inflammatory bowel disease (IBD) is a chronic illness with various treatments, including ostomy surgery. Ostomy‐related medical decision‐making (MDM) is complex for multidisciplinary healthcare professionals (HCPs). This study sought to understand national multidisciplinary HCPs' perceptions about pediatric IBD ostomy surgery in the United States.This cross‐sectional REDCap survey recruited HCPs in pediatric IBD HCP roles from the ImproveCareNow (ICN) Learning Health System. The survey gathered data on, (1) demographics, (2) participants' perspectives on patients/families' ostomy perceptions, (3) participants' own perspectives on ostomies, and (4) participants' perspectives on multidisciplinary collaboration in ostomy surgery.Participants (n = 69, across n = 30 American ICN sites) were 84% White, 62% female, and 54% gastroenterologists. In reflecting on patients/families' perceptions, participants endorsed most (86%) view ostomies as a “failure,” various psychosocial concerns (e.g., 97% endorsed body image concerns), and most (81%) have moderate to significant stigma about ostomies. In reflecting on their own perceptions, nearly half (44%) endorsed some to moderate stigma about ostomies and felt ostomy discussions were difficult when families had negative perceptions (88%). Over half (54%) endorsed currently having multidisciplinary care for pediatric IBD surgery. Most (70%) endorsed variability in the amount and/or quality of multidisciplinary collaboration.MDM related to pediatric IBD ostomy surgery presents nuanced clinical complexities for HCPs. This work underscores interest in multidisciplinary care, notable ostomy‐related psychosocial needs, and ostomy‐related stigma. Future work should develop systematic approaches to multidisciplinary pediatric IBD ostomy care, bolster psychosocial support, and evaluate how systematic care may impact psychosocial, and healthcare utilization outcomes.
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