Expressions of conflict following postoperative complications in older adults having major surgery.
Expressions of conflict following postoperative complications in older adults having major surgery.
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DOI：
10.1016/j.amjsurg.2021.06.004
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发表时间：
2021-10
影响因子：
3
通讯作者：
Schwarze ML
中科院分区：
文献类型：
--
作者：
Kalbfell EL;Buffington A;Kata A;Brasel KJ;Mosenthal AC;Cooper Z;Finlayson E;Schwarze ML
严重的术后并发症后，患者和家属可能会对护理目标产生冲突。我们进行了一项多地点随机临床试验，以测试问题提示列表对术后冲突的影响。我们采访了有严重并发症的家庭成员和年龄≥60岁的患者。我们使用定性内容分析来分析冲突并描述患者并发症的经历。446例患者中有56例出现严重并发症。参与者一般没有报告与术后治疗有关的冲突，并表示支持他们接受的护理。我们没有意识到干预和常规护理之间冲突的差异。受访者报告说，他们对并发症感到措手不及，目睹了团队成员之间激烈的互动，以及未能在术前建立对外科医生的信任。严重并发症后的术后冲突有很好的描述，但其发生率可能很低。尽管如此，病人和家属的观察显示出改善的机会。
After serious postoperative complications, patients and families may experience conflict about goals of care. We performed a multisite randomized clinical trial to test the effect of a question prompt list on postoperative conflict. We interviewed family members and patients age ≥ 60 who experienced serious complications. We used qualitative content analysis to analyze conflict and characterize patient experiences with complications. Fifty-six of 446 patients suffered a serious complication. Participants generally did not report conflict relating to postoperative treatments and expressed support for the care they received. We did not appreciate a difference in conflict between intervention and usual care. Respondents reported feeling unprepared for complications, witnessing heated interactions among team members, and a failure to develop trust for their surgeon preoperatively. Postoperative conflict following serious complications is well described but its incidence may be low. Nonetheless, patient and family observations reveal opportunities for improvement.
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影响因子：
38.9
作者：
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通讯作者：
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