小儿炎症性肠病(IBD)是一种慢性疾病,患者可能会接受造口术。造口术的医疗决策(MDM)对于患者/家庭和多学科医疗保健专业人员(HCP)来说是复杂的。目前不确定多学科HCP如何考虑造口护理,以告知未来的干预措施,以促进对患者的公平多学科护理。这项研究旨在了解小儿IBD多学科HCP对造口相关MDM和教育的看法。多学科HCP(例如,胃肠病学医疗提供者,社会工作者,外科医生,和造口护士)参加了半结构化焦点小组。焦点小组的数据进行了定性分析,以确定主题。进行了三个多学科焦点小组,所有组的n=12名参与者。定性分析确定了三个主要主题,包括(1)HCP对造口的看法,(2)患者/家庭相关因素,(3)专业角色和协作挑战。小儿IBD的造口术需要复杂的多学科MDM和教育。多学科HCPs识别患者的观点,HCP,以及可能影响造口术MDM的系统因素。这项工作突出了MDM和IBD教育中的细微差别,以及正在进行的研究和改进的标准化流程的关键作用,以协调该人群中与造口术相关的多学科MDM和教育。
Pediatric Inflammatory Bowel Disease (IBD) is a chronic illness where patients may undergo
ostomy surgery. Medical decision-making (MDM) for
ostomy surgery is complex for patients/families and multidisciplinary healthcare professionals (HCPs) alike, with current uncertainty about how multidisciplinary HCPs think about ostomy care to inform future interventions to facilitate equitable multidisciplinary care for patients. This study sought to understand pediatric IBD multidisciplinary HCPs\' perceptions regarding
ostomy-related MDM and education. Multidisciplinary HCPs (e.g., gastroenterology medical providers, social workers, surgeons, and
ostomy nurses) participated in semi-structured focus groups. Focus group data underwent qualitative analysis to identify themes. Three multidisciplinary focus groups were conducted, with n = 12 participants across all groups. Qualitative analysis identified three main themes, including (1) HCP perceptions of ostomies, (2) Patient/family-related factors, and (3) Professional roles and collaboration challenges.
Ostomy surgery in pediatric IBD requires complex multidisciplinary MDM and education. Perspectives of multidisciplinary HCPs identified patient, HCP, and systems factors that may impact MDM for ostomy surgery. This work highlights nuances in MDM and education in IBD, and the critical role of ongoing research and improved standardized processes to coordinate multidisciplinary ostomy-related MDM and education in this population.