Exploring Web-Based Twitter Conversations Surrounding National Healthcare Decisions Day and Advance Care Planning From a Sociocultural Perspective: Computational Mixed Methods Analysis.
Exploring Web-Based Twitter Conversations Surrounding National Healthcare Decisions Day and Advance Care Planning From a Sociocultural Perspective: Computational Mixed Methods Analysis.
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DOI：
10.2196/35795
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发表时间：
2022-04-13
影响因子：
2.2
通讯作者：
Sullivan, Suzanne S.
中科院分区：
文献类型：
--
作者：
Lattimer, Tahleen A.;Tenzek, Kelly E.;Ophir, Yotam;Sullivan, Suzanne S.
关键词：
在美国的文化和社会中，与死亡和临终有关的话题仍然是禁忌，因此，在生命结束时出现和参与的机会，可能导致一个好的死亡，是避免的。已经做出了一些努力来帮助人们参与预先护理计划（ACP）对话，包括完成预先护理指示，以便他们在病得太重而无法表达自己的愿望时表达自己的护理目标。在美国，鼓励这种具有挑战性的讨论的主要努力是每年庆祝国家医疗保健决策日。本研究旨在以Twitter为沟通工具，从社会文化的角度探讨ACP。收集2020年8月1日至2021年7月30日期间发布的所有公开可用推文（N=9713），并使用计算混合方法Analysis of Topic Model Network方法进行分析。结果显示，主要由外行人驱动的对话（7107/7410,95.91%的推文来自未经验证的账户）围绕以下三个主题：重要性和推广，周围语言和系统问题。基于这些结果，我们认为有必要意识到人们在参与ACP对话时可能面临的障碍，包括系统障碍、文化水平、错误信息、政策（包括医疗保险报销）以及美国医疗保健专业人员之间的信任。这对全世界的临床医生和学者来说是非常重要的，因为我们正在努力重新设想ACP，这样人们就能更轻松地参与ACP对话。就推文的内容而言，我们认为ACP的生物医学和生物心理社会元素之间存在鸿沟，包括患者叙述。如果使用得当，Twitter对话和国家医疗保健决策日标签可以作为组织、医生、患者和家庭成员之间的连接点，为走向美好死亡奠定基础。
Within the cultures and societies of the United States, topics related to death and dying continue to be taboo, and as a result, opportunities for presence and engagement during the end of life, which could lead to a good death, are avoided. Several efforts have been made to help people engage in advance care planning (ACP) conversations, including completing advance care directives so that they may express their goals of care if they become too sick to communicate their wishes. A major effort in the United States toward encouraging such challenging discussions is the annual celebration of the National Healthcare Decisions Day. This study aimed to explore ACP from a sociocultural perspective by using Twitter as a communication tool. All publicly available tweets published between August 1, 2020, and July 30, 2021 (N=9713) were collected and analyzed using the computational mixed methods Analysis of Topic Model Network approach. The results revealed that conversations driven primarily by laypersons (7107/7410, 95.91% of tweets originated from unverified accounts) surrounded the following three major themes: importance and promotion, surrounding language, and systemic issues. On the basis of the results, we argue that there is a need for awareness of the barriers that people may face when engaging in ACP conversations, including systemic barriers, literacy levels, misinformation, policies (including Medicare reimbursements), and trust among health care professionals, in the United States. This is incredibly important for clinicians and scholars worldwide to be aware of as we strive to re-envision ACP, so that people are more comfortable engaging in ACP conversations. In terms of the content of tweets, we argue that there is a chasm between the biomedical and biopsychosocial elements of ACP, including patient narratives. If used properly, Twitter conversations and National Health Care Decision Day hashtags could be harnessed to serve as a connecting point among organizations, physicians, patients, and family members to lay the groundwork for the trajectory toward a good death.
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影响因子：
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作者：
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通讯作者：
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DOI：
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发表时间：
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