摘要
目的:探讨患者参与式决策辅助在心脏瓣膜置换患者中的应用效果。方法:采用便利抽样法,选取南京医科大学第一附属医院2020年6—11月住院行心脏瓣膜置换术的38例患者作为对照组,2021年1—5月住院行心脏瓣膜置换术的38例患者作为试验组。对照组给予常规护理干预,试验组在常规护理基础上实施患者参与式决策辅助方案的干预。于入院日、手术前1 d采用决策冲突量表(DCS)、决策准备量表(PrepDM)和慢性病患者风险感知问卷进行评价。结果:入院日,2组DCS、PrepDM和慢性病患者风险感知问卷得分比较差异无统计学意义(P>0.05)。手术前1 d,试验组DCS中信息和价值观维度、决策支持与决策有效性维度、决策不确定性维度得分及总分分别为(12.37±4.11)、(12.50±4.65)、(3.74±1.17)、(28.61±7.07)分,低于对照组的(15.11±3.62)、(17.84±4.25)、(4.37±1.30)、(37.32±6.57)分,差异有统计学意义(t值为2.22~5.56,均P<0.05)。手术前1 d,试验组PrepDM得分为(73.58±5.32)分,高于对照组的(67.82±4.89)分,差异有统计学意义(t=4.92,P<0.05)。手术前1 d,试验组慢性病患者风险感知问卷中经济风险维度、身体诊疗风险维度、社会心理风险维度得分及总分分别为(11.45±3.94)、(12.39±3.64)、(7.21±4.09)、(31.05±6.11)分,低于对照组的(13.50±3.73)、(15.82±5.18)、(9.32±3.59)、(38.63±7.27)分,差异有统计学意义(t值为2.33~4.92,均P<0.05)。结论:患者参与式决策辅助可降低心脏瓣膜置换患者决策冲突,提高术前决策准备度,减轻患者风险感知水平。
Objective To explore the effects of application of the patient participation decision aid in patients undergoing cardiac valve replacement.Methods A total of 38 patients hospitalized for cardiac valve replacement from June to November,2020 in the First Affiliated Hospital of Nanjing Medical University,were enrolled as the control group,and 38 patients admitted from January to May,2020,were recruited as the experimental group by convenient sampling method.The control group was given routine nursing intervention,while the experimental group was carried out patient participation decision aid assistant program on the basis of routine nursing.The effects of intervention were assessed by Decision Conflict Sale(DCS),Preparation for Decision Making(PrepDM)and Risk Perception Questionnaire for patients with chronic diseases at admission and one day before operation.Results There was no significant difference in the scores of DCS,PrepDM and Risk Perception Questionnaire for patients with chronic diseases at admission between the two groups(P>0.05).At one day before operation,the information&values scores dimension,support and valid decision dimension scores,decision uncertainty dimension scores and total scores of DCS were(12.37±4.11),(12.50±4.65),(3.74±1.17),(28.61±7.07)points in the experimental group,lower than those in the control group(15.11±3.62),(17.84±4.25),(4.37±1.30),(37.32±6.57)points,the differences were statistically significant between the two groups(t values were 2.22-5.56,all P<0.05).At one day before operation,the score of PrepDM was(73.58±5.32)points in the experimental group,higher than that in the control group(67.82±4.89)points,the difference was statistically significant(t=4.92,P<0.05).At one day before operation,the scores of economic risk dimension,physical and medical risk dimension,psychosocial risk dimension scores and total scores of Risk Perception Questionnaire for patients with chronic diseases were(11.45±3.94),(12.39±3.64),(7.21±4.09),(31.05±6.11)points in the experimental grou
作者
陆艳艳
张慧婷
管玉珍
Lu Yanyan;Zhang Huiting;Guan Yuzhen(Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《中国实用护理杂志》
2022年第27期2120-2126,共7页
Chinese Journal of Practical Nursing
关键词
决策支持系统
临床
决策
心脏瓣膜置换术
风险感知
Decision support systems,clinical
Decision making
Cardiac valve replacement
Risk perception
