慢性肾脏病病人透析治疗决策困境现状及影响因素  

Status quo and influencing factors of decisional conflict of dialysis treatments in patients with chronic kidney disease

作　　者：王雯雯 曹艳佩[2] 黄晓敏[3] 顾爱萍[4] 袁立[2] 卫尹[2] WANG Wenwen;CAO Yanpei;HUANG Xiaomin;GU Aiping;YUAN Li;WEI Yin(School of Nursing,Fudan University,Shanghai 200032 China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属华山医院 [3]上海交通大学医学院附属瑞金医院 [4]上海交通大学医学院附属仁济医院

出　　处：《护理研究》2020年第23期4129-4134,共6页Chinese Nursing Research

基　　金：上海市闵行区自然科学研究课题,编号:2019MHZ064。

摘　　要：[目的]了解慢性肾脏病(CKD)病人透析治疗决策困境的现状并分析其影响因素。[方法]采用方便抽样的方法,选择上海市3所三级甲等医院肾病门诊或CKD门诊随访CKD 4期或5期病人95例。采用一般资料调查表和决策困境量表(DCS)对CKD病人进行调查。[结果]CKD病人DCS总分为(33.88±9.85)分,其中信息提供得分为(37.54±14.98)分,价值观明确得分为(46.23±13.02)分,社会支持得分为(26.84±14.29)分,不确定性得分为(30.95±16.92)分,决策有效性得分为(29.34±12.86)分。多元线性回归分析显示,透析前教育情况、个人月收入和受教育程度是CKD病人透析治疗决策困境的影响因素(P<0.05)。[结论]CKD病人透析决策困境水平较高,医护人员应评估病人透析前教育情况、个人月收入和受教育程度等影响因素,制定个性化的透析决策支持措施,降低病人决策困境程度,提高决策质量。Objective:To investigate status quo of decisional conflict of dialysis treatment in patients with chronic kidney disease(CKD),and to analyze its influencing factors.Method:Totally 95 patients with stage CKD 4 or stage CKD 5 of nephrology clinic or CKD clinic in 3 tertiary grade A hospitals in Shanghai,were selected by convenient sampling.Questionaire investigation was carried out by using general data questionnaire and Decisional Conflict Scale(DCS).Results:The total score of DCS among CKD patients was 33.88±9.85.The scores of information,values,social support,uncertainty and decision effectiveness were 37.54±14.98,46.23±13.02,26.84±14.29,30.95±16.92 and 29.34±12.86,respectively.Multiple linear regression analysis showed that pre⁃dialysis education,personal monthly income and education level were the influencing factors of decisional conflict of dialysis treatments in CKD patients.Conclusion:CKD patients had a high level of dialysis decisional conflict.Medical staff should evaluate the influencing factors such as pre⁃dialysis education,personal monthly income and education level,and formulate personalized dialysis decision support measures,so as to reduce the degree of decisional conflict and improve the quality of decision⁃making.

关 键 词：慢性肾脏病 透析 决策困境 调查研究 影响因素 现状 

分 类 号：R473.5[医药卫生—护理学]