摘要
目的:研制基于共同决策理念的原发性房角关闭病人激光治疗决策辅助工具,为病人提供专业的决策支持,提高决策质量,促进医患共同决策。方法:基于渥太华决策支持框架和国际病人决策辅助工具标准,通过文献分析形成原发性房角关闭病人激光治疗决策辅助工具初稿;经2轮专家咨询,整合青光眼临床医学、眼科护理及公共卫生管理领域专家的意见形成修订版;通过临床调研了解病人及医务人员对工具可接受性的评价,进一步完善形成终稿。结果:共有19名专家完成专家咨询,专家积极性为95.0%、权威系数为0.918。2轮专家咨询后,该工具各级指标的协调系数分别为0.131,0.224和0.187(P<0.05)。临床调研发现,病人和医务人员对该工具的接受度高,认为其易于理解和使用,能够辅助决策。最终,原发性房角关闭病人激光治疗决策辅助工具包含阐明决策、评估决策需求、提供信息、分析风险收益、澄清价值观、引导决策制定和确认决策7项一级指标以及15项二级指标、32项三级指标。结论:原发性房角关闭病人激光治疗决策辅助工具具有一定的科学性和临床适用性,为病人参与病人安全,实现医患共同决策提供了科学、有效的支持手段。
Objective:Develop a decision aid for laser therapy of patients with primary angle closure based on the shared decision-making concept to provide professional decision support for patients,improve the quality of decision-making and promote shared decision-making.Methods:Based on the Ottawa Decision Support Framework and International Patient Decision Aids Standard,the first draft of the laser therapy decision aid for patients with primary angle closure was developed through literature analysis.Through two rounds of expert consultation,integrating input from experts in the fields of glaucoma clinical medicine,ophthalmic nursing and public health management,resulting in a revised version.Clinical investigation was conducted to understand the evaluation of the acceptability of the tool by patients and medical staffs,and the tool was further refined to form the final draft.Results:A total of 19 experts completed this expert consultation with a positivity of 95.0%and an authority factor of 0.918.After two rounds of expert consultation,the Kendall′s W for each indicator of the tool were 0.131,0.224 and 0.187 respectively(P<0.05),indicating that the experts were more accepting of the content of the tool and had a good degree of harmonization of opinions.Clinical investigation found a high level of acceptance of the tool by patients and medical staffs,who found it easy to understand and use,and able to assist in decision-making.The final laser therapy decision aid for patients with primary angle closure contains 7 primary indicators:clarify decision,assess decision needs,provide information,analyse risk-benefit,clarify values,guide decision making and confirm decision,15 secondary indicators and 32 tertiary indicators.Conclusion:The laser therapy decision aid for patients with primary angle closure is scientifically and clinically applicable,and provides a scientific and effective means of supporting patient participation in their own safety management and achieving shared decision-making.
作者
孙怡雯
陈燕燕
左舒舒
陆湖洁
华怡婷
周文哲
SUN Yiwen;CHEN Yanyan;ZUO Shushu;LU Hujie;HUA Yiting;ZHOU Wenzhe(School of Ophthalmology and Optometry,Biomedical Engineering,Wenzhou Medical University,Zhejiang 325027 China)
出处
《护理研究》
北大核心
2024年第3期390-398,共9页
Chinese Nursing Research
基金
2022年温州市基础性科研项目,编号:Y20220155。
