Educational Resources and Self-Management Support to Engage Patients in Advance Care Planning: An Interpretation of Current Practice in the US.
Educational Resources and Self-Management Support to Engage Patients in Advance Care Planning: An Interpretation of Current Practice in the US.
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DOI：
10.1177/10499091211064834
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发表时间：
2022-08
影响因子：
1.9
通讯作者：
Ladin, Keren
中科院分区：
文献类型：
--
作者：
Gazarian, Priscilla;Gupta, Avni;Reich, Amanda;Perez, Stephen;Semco, Robert;Prigerson, Holly;Ashana, Deepshikha;Dey, Tanujit;Carlston, Daniel;Cooper, Zara;Weissman, Joel;Ladin, Keren
教育资源和决策辅助工具可帮助患者、其护理伙伴和医疗保健提供者准备并自信地参与高级护理计划（ACP）。将ACP资源作为自我管理方法的一部分，可能会导致ACP更充分地参与，而不仅仅是确定代理决策者，而是支持一个人确定他们的价值观和目标，并与他们的护理伙伴和医疗保健提供者进行沟通。研究教育资源和决策辅助工具的使用，以支持美国11个卫生系统的ACP自我管理。本研究是一项定性访谈研究，探讨了ACP的障碍和促进因素。在解释性描述和慢性病护理模型的指导下，我们试图描述医疗保健利益相关者（临床医生和管理人员）和患者如何使用ACP资源来支持与ACP的合作。采访了274名医疗保健利益相关者，并在11个卫生系统中进行了7个患者焦点小组讨论。大多数与会者报告说，他们利用资源支持完成优惠文件，较少的与会者利用资源促进更多地参与非加太国家。据报告，非加太国家方案的资源在筹备和补充一个复杂的、人际的和跨专业的进程方面很有价值。使用资源的障碍包括缺乏明确的工作流程和时间。我们的数据表明，非加太国家的资源，促进参与的价值，但在实践中利用不足。利用非加太国家的资源，同时建立一个跨专业小组，并采取自我管理的办法，是一项很有希望的战略，可以减少执行非加太国家的障碍，同时改善对非加太国家的参与。
Educational resources and decision aids help patients, their care partners and health care providers prepare for and confidently engage in Advance Care Planning (ACP). Incorporating ACP resources as part of a self-management approach may lead to fuller engagement with ACP beyond identifying a surrogate decision-maker, towards supporting a person to identify their values and goals and to communicate them with their care partners and health care providers. To examine the use of educational resources and decision aids to support self-management of ACP in 11 health systems across the US. This study was a qualitative interview study examining barriers and facilitators to ACP. Guided by interpretative description and the chronic care model, we sought to describe how health care stakeholders (clinicians and administrators) and patients use ACP resources to support engagement with ACP. 274 health care stakeholders were interviewed, and 7 patient focus groups were conducted across 11 health systems. The majority of participants reported using resources to support completion of preference documentation, with fewer participants using resources that promote more engagement in ACP. ACP resources were reported as valuable in preparing for and complementing a complex, interpersonal, and interprofessional process. Barriers to using resources included a lack of a defined workflow and time. Our data suggest that ACP resources that promote engagement are valued but under-utilized in practice. The use of ACP resources with an interprofessional team and a self-management approach is a promising strategy to mitigate the barriers of ACP implementation while improving engagement in ACP.
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影响因子：
1.9
作者：
McGowan, Patrick T.
通讯作者：
McGowan, Patrick T.
DOI：
10.9778/cmajo.20190179
发表时间：
2020-04-01
期刊：
CMAJ open
影响因子：
--
作者：
Heyland, Daren K;Heyland, Rebecca;Howard, Michelle
通讯作者：
Howard, Michelle
影响因子：
2.9
作者：
Bernard, Carrie;Tan, Amy;Howard, Michelle
通讯作者：
Howard, Michelle
影响因子：
2.9
作者：
Howard M;Bonham AJ;Heyland DK;Sudore R;Fassbender K;Robinson CA;McKenzie M;Elston D;You JJ
通讯作者：
You JJ
影响因子：
13.8
作者：
Nouri S;Lyles CR;Rubinsky AD;Patel K;Desai R;Fields J;DeRouen MC;Volow A;Bibbins-Domingo K;Sudore RL
通讯作者：
Sudore RL