影响医疗保健专业人员在医院病房共同决策的因素：一项定性研究。

IF 2.7 4区医学 Q1 NURSING

Applied Nursing Research Pub Date : 2025-02-01 DOI:10.1016/j.apnr.2024.151892

J. Bakker , E.M. Huntink , L.J. Peters , I.M. Brugman , D.T. Ubbink , L. Schoonhoven

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引用次数: 0

摘要

目的：医疗保健专业人员在医院病房应用共享决策（SDM）的程度仍然未知。目的是探索目前卫生保健专业人员对SDM的了解，以及影响荷兰医院病房SDM的经验因素，包括治疗和护理决策。环境：两所大学医疗中心的12个病房和一所教学医院。设计：探索性定性设计，包括对在医院病房工作的医疗保健专业人员的半结构化访谈。结果：对12个不同病房的23名医护人员进行了问卷调查，了解他们对病房SDM的认知情况以及影响SDM的因素。大多数医疗保健专业人员都听说过SDM，但他们对SDM概念的理解不同。影响因素有三个层次。组织因素：缺乏清晰的愿景，查房方式多样，时间，组织结构。患者相关因素：患者的处境、亲属的参与、感知差异。与医疗保健专业相关的因素：动机、经验、工作量、护理的连续性、对患者的熟悉程度、专业间沟通、工具和教育。结论：所有医疗保健专业人员都认识到SDM的重要性，并使患者参与医疗保健决策，因为他们认为它可以提高护理质量，优先考虑以患者为中心的护理。然而，医疗保健专业人员在这种情况下经常遇到障碍。为了促进荷兰医院病房的SDM，将SDM嵌入住院环境并建立一个明确的关于治疗和护理决策的跨专业SDM结构是有益的，在这个结构中，医生、护士和患者发挥重要作用。

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Factors influencing shared decision-making on hospital wards as perceived by healthcare professionals: A qualitative study

Objectives

The extent to which healthcare professionals apply Shared Decision Making (SDM) on hospital wards is still unknown. The aim was to explore the current knowledge of SDM among healthcare professionals and the experienced factors influencing SDM on the wards of Dutch hospitals, regarding both treatment and care decisions.

Setting

Twelve hospital wards in two university medical centres and one teaching hospital.

Design

Explorative qualitative design including semi-structured interviews with healthcare professionals working on hospital wards.

Results

23 Healthcare professionals of 12 different wards were interviewed about their knowledge and the factors influencing SDM on their hospital ward. Most healthcare professionals had heard about SDM, but their understanding of the concept of SDM differed. Influencing factors were found on three levels. Organizational factors: lack of a clear vision, various approaches of ward rounds, time, and the organizational structure. Patient-related factors: the situation of the patient, participation of relatives and perceptual differences. Healthcare professional-related factors: motivation, experience, workload, continuity of care, familiarity with the patient, interprofessional communication, tools, and education.

Conclusion

All healthcare professionals recognize the importance of SDM and involving the patient in healthcare decisions, because they feel it enhances the quality of care and prioritizes patient-centered care. Nevertheless, healthcare professionals frequently encounter barriers in this setting. To facilitate SDM on hospital wards in the Netherlands, it is beneficial to embed SDM in the inpatient setting and establish a clear structure for interprofessional SDM regarding both treatment and care decisions, in which physicians, nurses and patients play an essential role.

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来源期刊

Applied Nursing Research 医学-护理

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

70 days

期刊介绍： Applied Nursing Research presents original, peer-reviewed research findings clearly and directly for clinical applications in all nursing specialties. Regular features include "Ask the Experts," research briefs, clinical methods, book reviews, news and announcements, and an editorial section. Applied Nursing Research covers such areas as pain management, patient education, discharge planning, nursing diagnosis, job stress in nursing, nursing influence on length of hospital stay, and nurse/physician collaboration.