Communication about life-sustaining therapy: insights from the Adaptive Leadership Framework.
Communication about life-sustaining therapy: insights from the Adaptive Leadership Framework.
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DOI：
10.5750/ejpch.v1i2.682
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Docherty SL
中科院分区：
文献类型：
--
作者：
Neglia E;Anderson RA;Brandon D;Docherty SL
在治疗危及生命的疾病期间，有效的提供者和护理人员沟通是优质护理的核心。这项研究的目的是分析供应商和父母之间的沟通模式，使用适应性领导框架，这是一项活动，涉及动员他人适应困难的情况下，有生命危险的疾病的婴儿。对一例病例进行了二次分析，使用了23次与诊断为Hurler综合征的婴儿的母亲和供应商的访谈。访谈的重点是婴儿治疗方面的决策挑战，并在1年内进行（移植前，研究入组，每月，危及生命的事件或治疗的实质性变化后和入组后1年）。内容分析被用来识别和分类的通信模式使用的概念，从适应性领导框架。婴儿疾病事件和父母-提供者的关系记录在1年的轨迹中。尽管Hurler病具有危及生命的性质，但父母和提供者没有讨论姑息治疗或临终关怀。家长向供应商寻求指导和答案。适应性领导框架表明沟通方法往往与父母的需求不匹配。这项研究的结果强调，需要改善供应商和父母之间的沟通，为他们的孩子的生命结束。适应性领导阐明了供应商如何能够影响父母的行为时，面对一个具有挑战性的情况。这项研究表明，适应性领导是一个有用的框架，以指导研究医疗保健沟通在处理具有挑战性的问题。
Effective provider and caregiver communication is central to quality care during treatment for life-threatening illnesses. The study aim was to analyze communication patterns between providers and a parent of an infant with a life-threatening disease using the Adaptive Leadership Framework, which is an activity that involves mobilizing others to adapt to a difficult situation. A secondary analysis was conducted on one case using 23 interviews with providers and mother of an infant diagnosed with Hurler’s syndrome. The interviews focused on decision-making challenges in regard to the infant’s treatment and were conducted over a 1-year period (pre-transplant, study entry, monthly, after a life-threatening event or substantial change in treatment and at 1-year post enrollment). Content analysis was used to identify and categorize communication patterns using concepts from the Adaptive Leadership Framework. Infant illness events and parent-provider caregiving were chronicled across a 1-year trajectory. Despite the life-threatening nature of Hurler’s disease, the parent and providers did not discuss palliative care or end-of-life. The parent sought direction and answers from the providers. The Adaptive Leadership Framework suggested how communication approaches were often mismatched with the needs of the parent. The results of the study accentuate the need to improve communication between provider and parents about end-of-life for their child. Adaptive Leadership illuminates how providers can influence a parent’s behavior when facing a challenging situation. This study suggests that Adaptive Leadership is a useful framework to guide research about healthcare communication in dealing with challenging issues.