主动脉夹层手术决策辅助工具的构建与应用研究  

Development and application of a patient decision aid for choice of surgical management for aortic dissection

作　　者：张舵 周雁荣[1] 吴前胜 潘友民[2] 郑智[2] 查正彪[2] 刘娟[1] 王萧萧 朱利思 胡凯利 李碧稳 梅凌寒 Zhang Duo;Zhou Yanrong;Wu Qiansheng;Pan Youmin;Zheng Zhi;Zha Zhengbiao;Liu Juan;Wang Xiaoxiao;Zhu Lisi;Hu Kaili;Li Biwen;Mei Linghan(Department of Nursing,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院心脏大血管外科,湖北武汉430030

出　　处：《护理学杂志》2024年第3期31-35,共5页Journal of Nursing Science

基　　金：湖北省卫生健康委2023-2024年度科研项目(WJ2023M007);2021年华中科技大学同济医学院护理学院自主创新项目(2021-03-10);2021年华中科技大学同济医学院护理学院研究生教学改革研究项目(2021-05)。

摘　　要：目的构建主动脉夹层手术决策辅助工具,提高主动脉夹层患方决策者的决策质量。方法通过文献分析、专家函询、用户调适等形成主动脉夹层决策辅助工具,于2022年8-10月将心脏大血管外科主动脉夹层手术的患方决策者按病区分为对照组和干预组各35例。对照组行常规健康宣教及术前谈话,干预组在此基础上使用决策辅助工具。比较两组出院前决策冲突、决策准备度、决策满意度。结果主动脉夹层决策辅助工具包含4项一级指标,9项二级指标,31项三级指标。干预组决策冲突得分显著低于对照组,决策准备度及满意度得分显著高于对照组(均P<0.05)。结论主动脉夹层手术决策辅助工具具有科学性和实用性,可以减轻患方决策者决策冲突,提高决策质量,实现医患共享决策。Objective To develop a patient decision aid(PtDA)for choice of surgical management for aortic dissection and to improve decision quality in patients and their families.Methods A PtDA for choice of surgical management for aortic dissection was deve-loped through literature review,expert consultation,and user adaptation.Patients with aortic dissection admitted to the department of cardiovascular surgery in August to October,2022,were assigned to two groups according to the ward where the patient was hospitalized,with 35 in each group.The control group was given routine health education and preoperative conversation,while the intervention group additionally received PtDA for education.Decisional conflict,decision preparation,and satisfaction were compared between the two groups before discharge.Results The PtDA included 4 primary indicators,9 secondary indicators and 31 tertiary indicators.The score of decisional conflict was significantly lower,whereas the scores of decision preparation and satisfaction were significantly higher in the intervention group compared with the control group(all P<0.05).Conclusion PtDA for choice of surgical management for aortic dissection is scientific and practical,which can be used to ameliorate decisional conflict and improve decision quality,resulting in achieving shared decision-making between patients and healthcare providers.

关 键 词：主动脉夹层 手术 决策者 决策辅助 决策准备度 决策冲突 共享决策 心外科护理 

分 类 号：R473.6[医药卫生—护理学]