مجله علوم پزشکی پارس
تبیین تجارب دستیاران گروه داخلی دانشگاه علوم پزشکی جهرم از عوامل و موانع موثر بر تصمیم گیری بالینی: یک مطالعه کیفی
نوع مقاله : مقاله پژوهشی
نویسندگان
1 استادیار، گروه داخلی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.
2 استادیار گروه داخلی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.
3 رزیدنت گروه داخلی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.
4 مرکز تحقیقات عوامل اجتماعی موثر بر سلامت،دانشگاه علوم پزشکی جهرم، جهرم، ایران
چکیده
مقدمه: تصمیم گیری بالینی بر اساس تفسیر و ارزیابی داده های جمع آوری شده انجام می شود، تا از میان راه های مختلف، طرح درمانی مناسب مبتنی بر شواهد انتخاب شود. تصمیم گیری در محیط بالین با شرایط پویا، متغیر، نامطمئن و غیرپایدار، ابعاد مختلفی داشته و عوامل متعددی بر آن اثرگذار است به طوری که با مطالعات اندک و مقطعی نمی توان شناخت عمیقی نسبت به آن پیدا کرد. از این رو، مطالعه حاضر با هدف تبیین تجارب دستیاران گروه داخلی در خصوص عوامل و موانع موثر بر تصمیم گیری بالینی در
بیمارستان های وابسته به دانشگاه علوم پزشکی جهرم انجام شد.
روش کار: این پژوهش یک مطالعه تحلیل محتوای قراردادی بود که طی آن هشت دستیار گروه داخلی از بیمارستان‌های وابسته به دانشگاه علوم پزشکی جهرم به روش نمونه‌گیری هدفمند انتخاب و در مطالعه مشارکت کردند. جمع‌آوری داده‌ها به روش مصاحبه فردی عمیق نیمه ساختارمند انجام شد. کلیه مصاحبه‌ها ضبط و دست‌نویس شدند و سپس به روش گرانهایم و لاندمن مورد تجزیه و تحلیل قرار گرفتند.
یافته ها: در تحلیل داده ها چهار مضمون اصلی و 14 زیر طبقه مشخص شد. مضامین اصلی عبارت بودند از: معیارهای تصمیم گیری بالینی، موانع تصمیم گیری بالینی، تسهیل کننده های تصمیم گیری بالینی و ضرورت توسعه آموزش دستیاران.
نتیجه گیری: با توجه به این که تصمیم گیری بالینی بر پایه منفعت همه جانبه بیمار، اصول اخلاقی و شواهد انجام می گیرد وکمبود دانش نظری، تجربه اندک و مهارت ناکافی، نبودتخصص، کمبود تجهیزات وامکانات رفاهی مناسب همراه با فشار کاری می تواند تصمیم گیری درست را با مشکل مواجه سازد، بهتر است در برنامه ریزی آموزشی بر رفع کمبودهای مذکور تاکید بیشتری شود.
کلیدواژه‌ها
عنوان مقاله [English]
Explaining the experiences of internal medicine department assistants of Jahrom University of Medical Sciences regarding the factors and obstacles affecting clinical decision-making: a qualitative study
نویسندگان [English]
- Fatemeh Eftekharian 1
- Mahsa Parpaei 2
- Fatemeh Rahmanian 3
- Navid Kalani 4
- Jiila Rahmanian 2
1 Assistant Professor, Department of Internal Medicine, Jahrom University of medical sciences, Jahrom, Iran.
2 Assistant Professor, Department of Internal Medicine, Jahrom University of medical sciences, Jahrom, Iran.
3 Resident of Internal Medicine, Jahrom University of medical sciences, Jahrom, Iran.
4 Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
چکیده [English]
Introduction: Clinical decision-making is done based on data collection, interpretation and evaluation to choose an
evidence-based treatment plan from among different ways; Since the clinical environment has dynamic, variable, uncertain and unstable conditions, the clinical decision-making of assistants has different dimensions and is influenced by several factors; As a result, it is not possible to get a deep understanding of it with quantitative and cross-sectional studies; Therefore, the present study was carried out with the aim of explaining the experiences of internal department assistants on the factors and obstacles affecting clinical decision-making in hospitals affiliated to Jahrom University of Medical Sciences.
Materials and Methods: This article is a contract content analysis study in which 8 assistants of the internal medicine department from hospitals affiliated to Jahrom University of Medical Sciences were selected and participated in the
study by purposeful sampling. Semi-structured in-depth personal interview method was used to collect data. All interviews were recorded and then transcribed and analyzed using Granheim and Lundman's method.
Result: Data analysis revealed 4 main themes and 14 sub-categories, which main themes are: "criteria for clinical decision-making", "obstacles to clinical decision-making", "facilitators for clinical decision-making" and "the need for development" Training of assistants".
Conclusion: Considering that clinical decision-making is based on the comprehensive benefit of the patient, ethical
principles and evidence, and the lack of theoretical knowledge, little experience and insufficient skills, lack of specialists, facilities and equipment along with the lack of amenities and work pressure can prevent correct decision-making, it is better to emphasize more on these matters in educational planning.
کلیدواژه‌ها [English]
- Assistantship
- Internal Group
- Clinical Decision Making
- Qualitative Study
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