其他专家如何看待姑息关怀 发现他们的深层隐喻,以改进我们最初的推广策略。

IF 2.2 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of palliative medicine Pub Date : 2024-12-01 Epub Date: 2024-10-07 DOI:10.1089/jpm.2024.0248
Anthony L Back, Sanaya S Shikari, MaryGrace S King, Kathy C Shaw, Marian S Grant, Lindsay Zaltman
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引用次数: 0

摘要

许多本可从姑息关怀(PC)中获益的患者,却因专科医生介绍的时机和主旨而无法获得姑息关怀。提高专科医生(来自姑息关怀以外的学科)参与姑息关怀服务的一个障碍可能是对这些专科医生如何看待姑息关怀缺乏足够的了解。我们开展了一项定性市场调查研究,旨在识别专科医生对个体化护理所持有的 "深层隐喻",从而为更有效的宣传和信息传递提供实证基础。为了识别深层隐喻,我们使用了定性的扎特曼隐喻激发技术,从参与者的图像和访谈回答中发现思维模式,揭示更深层的情感含义和无意识的心理取向。我们招募了 20 名来自不同专业学科和专科的医疗服务提供者级别的临床医生,让他们参加一个小时的半结构化访谈,访谈前需要进行预习。我们对访谈进行了录像和转录,并采用恒定比较法的变体对访谈内容和参与者提供的图像进行了分析。主题包括必须告诉患者 "正确 "的信息和路径;不允许自己犯错;依赖于算法,这样我才能给患者提供最好的护理;让患者做主可以挑战临床算法;观察到 PC 似乎缺乏客观 "正确 "的决定;咨询 PC 引发的主观性最好包含在算法的末尾。这些主题可以为向其他重症专科临床医生进行宣传和传递信息的策略提供参考,从而降低他们对咨询 PC 的不情愿程度,增加患者的就医机会。
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How Other Specialists See Palliative Care Uncovering Their Deep Metaphors to Improve Our Initial Outreach Strategies.

Many patients who could benefit from palliative care (PC) do not access it because of the timing and tenor of the introduction provided by their specialist. A barrier to improving specialists' (from disciplines other than PC) engagement with PC services may be an inadequate understanding of how those specialists view PC. As part of a larger project to develop public messaging for advance care planning, PC, and hospice, we conducted a qualitative market research study aimed at identifying the "deep metaphors" held by specialists about PC to provide an empirical foundation for more effective outreach and messaging. To identify deep metaphors, we used the qualitative Zaltman Metaphor Elicitation Technique to uncover thought patterns from participants' images and interview responses, revealing deeper emotional meanings and unconscious mental orientations. We enrolled 20 provider-level clinicians from a variety of professional disciplines and specialties to participate in a one-hour semi-structured interview that required prework. The interviews were videorecorded and transcribed and were analyzed along with images brought by participants using a variation of the constant comparative method. The themes included: Having to tell patients the "right" information and path; Not allowing myself to make mistakes; Depending on algorithms so I can give my patients the best care; Putting the patient in charge can challenge clinical algorithms; Observing that PC seems to lack an objectively "right" decision; Consulting PC invites subjectivity best contained at the end of the algorithm. These themes can inform strategies for outreach and messaging to other serious illness specialist clinicians to lower reluctance to consult PC, increasing patient access.

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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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