Examining the Role of Primary Care Physicians and Challenges Faced When Their Patients Transition to Home Hospice Care.
Examining the Role of Primary Care Physicians and Challenges Faced When Their Patients Transition to Home Hospice Care.
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DOI：
10.1177/1049909117734845
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Adelman RD
中科院分区：
文献类型：
--
作者：
Shalev A;Phongtankuel V;Lampa K;Reid MC;Eiss BM;Bhatia S;Adelman RD
向家庭临终关怀的过渡通常是患者医疗护理的关键时刻。研究表明，患者和护理人员希望在临终 (EoL) 时能够继续与医生联系。然而，目前尚不清楚初级保健医生 (PCP) 扮演什么角色，以及他们在照顾过渡到家庭临终关怀的患者时面临哪些挑战。了解 PCP 在患者过渡到家庭临终关怀护理时的经历、挑战和偏好。对 PCP 进行了 19 次半结构化电话访谈。使用标准定性方法对研究数据进行分析。参与者包括来自纽约市 3 个学术团体实践的 PCP。使用内容分析来转录和分析医生的录音。大多数 PCP 指出，当患者过渡到家庭临终关怀护理时，他们的实际角色与理想角色之间存在差异。初级保健医生表示希望保持连续性、提供社会心理支持并与临终关怀团队积极合作。更好地建立角色、与临终关怀团队更频繁的沟通以及使用技术与患者沟通被认为是帮助 PCP 实现其理想角色，照顾接受家庭临终关怀的患者的可能方法。初级保健医生在患者过渡到家庭临终关怀期间表示了不同程度的参与，但许多人希望更多地参与患者的护理。与患者一样，医生希望在生命终止时与患者保持连续性，并且需要探索改善 PCP、临终关怀服务提供者和患者之间沟通的解决方案。
The transition into home hospice care is often a critical time in a patient’s medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. To understand PCPs’ experiences, challenges, and preferences when their patients transition to home hospice care. Nineteen semi-structured phone interviews with PCPs were conducted. Study data were analyzed using standard qualitative methods. Participants included PCPs from 3 academic group practices in New York City. Physician recordings were transcribed and analyzed using content analysis. Most PCPs noted that there was a discrepancy between their actual role and ideal role when their patients transitioned to home hospice care. Primary care physicians expressed a desire to maintain continuity, provide psychosocial support, and collaborate actively with the hospice team. Better establishment of roles, more frequent communication with the hospice team, and use of technology to communicate with patients were mentioned as possible ways to help PCPs achieve their ideal role caring for their patients receiving home hospice care. Primary care physicians expressed varying degrees of involvement during a patient’s transition to home hospice care, but many desired to be more involved in their patient’s care. As with patients, physicians desire to maintain continuity with their patients at the EoL and solutions to improve communication between PCPs, hospice providers, and patients need to be explored.
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影响因子：
14.6
作者：
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通讯作者：
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影响因子：
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作者：
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