Missed opportunity? Caregiver participation in the clinical encounter. A videographic analysis
Missed opportunity? Caregiver participation in the clinical encounter. A videographic analysis
复制标题
DOI：
10.1016/j.pec.2014.05.016
复制
发表时间：
2014-09-01
影响因子：
3.5
通讯作者：
LeBlanc, Annie
中科院分区：
文献类型：
--
作者：
Boehmer, Kasey R.;Egginfon, Jason S.;LeBlanc, Annie
目的：虽然护理人员的协助是至关重要的病人进行自我护理，很少有人知道他们参与访问和参与决策。我们试图通过videographic analysis.Methods检查这护理参与共享decision making通过：我们确定了从门诊就诊的医疗保健专业人员，病人和护理人员参加，从五个实践为基础的随机试验测试的决策援助与常规护理的疗效的视频记录。两个评论家，独立工作，编码的视频，以探讨护理人员参与的临床遭遇，临床医生的便利，参与，和决策援助的影响，在参与process.Results：在大多数的37个视频编码，护理人员的参与是自我触发。我们没有看到使用决策辅助工具对护理人员参与的影响。临床医生没有解决的照顾者的首选参与决策水平在任何视频记录encountersanalysed.Conclusion：在这项分析中，大多数临床医生没有从事照顾者在门诊慢性病护理。虽然使用决策辅助工具，提高了患者和临床医生之间的沟通，他们似乎并没有影响护理人员参与在consultations.Practice的影响：研究的比较有效性的方式来从事护理人员，以优化患者的重要成果，包括提高共享决策过程是必要的。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Objective: Although the assistance of caregivers is critical to patients undertaking self-care, little is known about their participation in visits and involvement in decision making. We sought to examine this caregiver participation in shared decision making through videographic analysis.Methods: We identified video recordings from outpatient visits in which a healthcare professional, patient, and caregiver participated, drawn from five practice-based randomized trials testing the efficacy of decision aids vs. usual care. Two reviewers, working independently, coded videos to explore caregiver engagement in the clinical encounter, clinician facilitation of that engagement, and the influence of decision aids in the engagement process.Results: In most of the 37 videos coded, caregivers' participation was self-triggered. We saw no impact of the use of decision aids on caregiver participation. Clinicians did not address the caregivers' preferred level of involvement in decision making in any of the video recorded encounters analyzed.Conclusion: In this analysis, most clinicians did not engage caregivers in outpatient visits for chronic care. While the use of decision aids improves communication between patient and clinician, they do not appear to affect caregiver involvement during consultations.Practice implications: Research on the comparative effectiveness of ways to engage caregivers to optimize patient-important outcomes, including enhancing the shared decision making process is necessary. (C) 2014 Elsevier Ireland Ltd. All rights reserved.