一种护士主导的方法来测试和调整远程医疗指南,以实现黑人慢性肾病患者护理对话的电子移情目标。

IF 2.9 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Patient Education and Counseling Pub Date : 2025-02-01 Epub Date: 2024-11-29 DOI:10.1016/j.pec.2024.108593
Adriana Glenn, Payton J Smith, Sherrie Flynt Wallington
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引用次数: 0

摘要

目的:探讨美国黑人慢性肾脏疾病(CKD)患者远程医疗访视中共情的表达(e-empathy),重点关注护理对话的目标。它旨在解决CKD,远程医疗进步,姑息治疗的讨论,以及种族主义在医疗保健的整体理解的影响的交集。方法:在华盛顿特区采用定性案例研究设计,涉及黑人慢性肾病患者。数据收集包括通过半结构化访谈进行认知测试和来自利益相关者咨询小组(SAG)的反馈。采用NVivo 20软件进行专题分析。结果:出现的主题包括移情定义、远程医疗理解、影响信心的因素、患者故事的重要性、文化意识、处理令人不安的谈话、优先考虑治疗偏好、临终决定和心理健康专业人员的定义。结论:本研究强调电子共情在黑人CKD患者远程医疗中的重要性,强调尊重、信任和有效沟通。它强调需要有文化针对性的指导,并承认自我选择偏见和小样本量等局限性。未来的工作应解决医疗保健差距和改善姑息治疗的讨论,包括虚拟预先指示。实践启示:在与黑人慢性肾病患者的远程医疗访问中,提供者应该优先考虑电子移情,在护理讨论的目标中培养信任和沟通,以改善患者的结果。
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A nurse-led approach to testing and adapting a telehealth guide for e-empathy in goals of care conversations for Black patients with chronic kidney disease.

Objective: This study aims to explore and enhance the expression of empathy in telehealth visits (e-empathy) with Black American Chronic Kidney Disease (CKD) patients, focusing on goals of care conversations. It seeks to address the intersection of CKD, telehealth advancements, palliative care discussions, and the impact of racism in healthcare for holistic understanding.

Methodology: A qualitative case study design was employed in Washington, DC, involving Black patients with CKD. Data collection included cognitive testing via semi-structured interviews and feedback from a Stakeholder Advisory Group (SAG). Thematic analysis was conducted using NVivo 20 software.

Results: Themes emerged regarding empathy definitions, telehealth understanding, factors influencing confidence, importance of patient stories, cultural awareness, handling upsetting conversations, prioritizing treatment preferences, end-of-life decisions, and definitions of mental health professionals.

Conclusion: The study highlights the significance of e-empathy in telehealth for Black CKD patients, emphasizing respect, trust, and effective communication. It underscores the need for culturally targeted guidance and acknowledges limitations such as self-selection bias and a small sample size. Future work should address healthcare disparities and improve palliative care discussions, including virtual advance directives.

Practice implications: Providers should prioritize e-empathy in telehealth visits with Black CKD patients, fostering trust and communication to improve patient outcomes during goals of care discussions.

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来源期刊
Patient Education and Counseling
Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
11.40%
发文量
384
审稿时长
46 days
期刊介绍: Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.
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