脑卒中康复团队沟通合作的质性研究  

Communication and cooperation within a stroke rehabilitation team:a qualitative research

作　　者：王啸鹤 肖树芹[1] 张璐[2] WANG Xiaohe;XIAO Shuqin;ZHANG Lu(Capital Medical University School of Nursing,Beijing 100069,China;Department of Neurorehabilitation,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]首都医科大学护理学院,北京市100069 [2]中国康复研究中心北京博爱医院神经康复一科,北京市100068

出　　处：《中国康复理论与实践》2023年第12期1473-1480,共8页Chinese Journal of Rehabilitation Theory and Practice

基　　金：首都医科大学科研培育基金项目(No.2018PYS05)。

摘　　要：目的调查脑卒中多学科团队医生、护士、康复治疗师(简称“医护治”)成员间沟通合作的阻碍因素及其原因。方法2022年7月至10月,以共享心智模型理论为指导,采用民族志方法,参与式观察12个康复评价会,半结构化访谈医生5例,护士10例,康复治疗师4例。结果呈现4个主题和9个子主题,包括设备(信息系统互操作性差、医护了解康复设备局限)、任务(成员参会时间压力大、学科间沟通制度不完善)、团队交互(信息共享不充分、角色/职责不熟悉、专业间理解差异)、团队成员(护士主动参与少、多学科相关知识局限)。结论脑卒中多学科团队医护治成员间的沟通合作受设备、任务、团队交互和团队成员等多种因素影响。提高信息系统互操作性,创造支持性环境,熟悉成员彼此角色/职责,加强学科间知识交叉,重视和支持护士能力的培养,有助于促进团队成员之间的高效沟通与合作。Objective To explore the obstacles and causes of communication and cooperation among doctors,nurses and rehabilitation therapists in a stroke rehabilitation team.Methods From July to October,2022,twelve rehabilitation evaluation meetings were observed using ethnographic research,based on Shared Mental Model theory.Semi-structured interviews were held with five doctors,ten nurses and four rehabilitation therapists.Results Four themes and nine sub-themes were presented,namely equipment(poor interoperability of information system,limited knowledge of rehabilitation equipment for doctors and nurses),task(members were under time pressure to attend meeting,imperfect inter-discipline communication system),team interaction(insufficient information sharing,unfamiliar with roles/responsibilities,misunderstanding between specialties)and team member(less participation of nurses,limited multidisciplinary knowledge).Conclusion The communication and cooperation among stroke rehabilitation team members is limited by many factors,such as equipment,task,team interaction and team members.It is suggested to improve interoperability of information systems,create a supportive environment,know each other's roles/responsibilities,strengthen interdisciplinary crossover,pay attention to and support the cultivation of nurses'ability,to promote efficient communica tion and cooperation among team members.

关 键 词：康复团队 沟通 合作 共享心智模型 康复评价会 脑卒中 质性研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]