摘要
目的:描述共享决策的阻碍及促进因素,为进一步临床实施共享决策提供依据。方法:采用便利抽样和目的抽样的方法,选取2019年2-4月上海市某三级甲等医院的16例乳腺癌患者进行半结构式访谈。采用归纳式内容分析法分析资料,具体步骤包括识别意义单位、压缩意义单位、编码、归纳亚主题及主题。结果:提炼出4个主题,9个亚主题,分别为患者角色认知因素(决策认知多元化、感知共享决策的需要);决策过程因素(信息交换、价值观澄清);医患互动情境因素(医患信任、决策支持、医患关系);临床情境因素(时间、工作量)。结论:乳腺癌患者共享决策的实施存在着一定的阻碍及促进因素,临床管理者应关注患者参与共享决策的需求,正确定位各因素在临床工作中的重要性,科学地构建符合我国国情的共享决策模式。
To explore the barriers and facilitators of breast cancer patients'participation in Shared Decision-Making,in order to provide reference for clinical implementation.Methods:By using purposive sampling and convenience sampling method,16 breast cancer patients were recruited for semi-structured interviews from February to April 2019.Inductive content analysis was used to analyze the data,including identifying the meaningful unit,compressing the meaningful unit,encoding,inducting categories and themes.Results:Four themes and nine categories were extracted,which were the patients'cognition(cognitive diversification,the need for Shared Decision-Making);decision-making process(information exchange,value clarification);doctor-patient interaction(doctor-patient trust,decision support,doctor-patient relationship);clinical situation(time,workload).Conclusion:Several influencing factors of breast cancer patients'Shared Decision-Making implementation were identified.Clinical managers should pay attention to the needs of patients participate in Shared Decision-Making and identify the superiority of the influencing factors in clinical work,in order to develop a suitable Shared Decision-Making model in China.
作者
郑红颖
杨林宁
尤婷婷
胡嘉乐
杨艳
ZHENG Hongying;YANG Linning;YOU Tingting;HU Jiale;YANG Yan(Department of Nursing,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200127,China)
出处
《中国护理管理》
CSCD
北大核心
2020年第10期1492-1496,共5页
Chinese Nursing Management
基金
上海市教委护理高原国际合作项目(Hlgy1802gj)。
关键词
乳腺癌
共享决策
阻碍因素
促进因素
描述性质性研究
breast cancer
Shared Decision-Making
barriers
facilitators
descriptive qualitative study
