糖尿病足患者截肢决策困境现状及影响因素研究  

Status quo and influencing factors of amputation decision-making dilemma in patients with diabetic foot

作　　者：王艳梅 王美君 曹灿灿 王冰洁 柴倩文 路明惠 魏力[5] Wang Yanmei;Wang Meijun;Cao Cancan;Wang Bingjie;Chai Qianwen;Lu Minghui;Wei Li(Department of General Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Diabetic Foot,Tianjin Medical University Chu Hsien-I Memorial Hospital,Tianjin 300134,China;Department of Pulmonary Tumor Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China;School of Nursing,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Nursing Department,Tianjin Medical University General Hospital Airport Hospital,Tianjin 300308,China)

机构地区：[1]天津医科大学总医院普外科,天津300052 [2]天津医科大学朱宪彝纪念医院糖尿病足科,天津300134 [3]天津医科大学总医院肺部肿瘤外科,天津300052 [4]天津中医药大学护理学院,天津301617 [5]天津医科大学总医院空港医院护理部,天津300308

出　　处：《中华现代护理杂志》2024年第33期4579-4584,共6页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2022—2023年护理学科研究课题(CMAPH-NRG2022040);2023年天津市滨海新区卫生健康科技项目(2023BWKQ014)。

摘　　要：目的调查糖尿病足患者截肢决策困境的现状及影响因素。方法采用便利抽样法,选取2023年7—12月在天津医科大学总医院和天津医科大学朱宪彝纪念医院住院治疗的200例糖尿病足患者为研究对象。使用一般资料调查表、决策困境量表(DCS)、家庭关怀度量表和医院焦虑抑郁问卷对患者进行横断面调查。采用Pearson相关分析对糖尿病足患者截肢决策困境与家庭关怀度、焦虑抑郁的相关性进行分析,采用多重线性回归分析对糖尿病足患者截肢决策困境的影响因素进行分析。结果本研究共发放问卷200份,回收有效问卷180份,问卷有效回收率为90.0%(180/200)。180例糖尿病足患者的DCS得分为(30.04±9.77)分,76.7%(138/180)的患者得分≥25.0分,存在决策困境;25.0%(45/180)的患者得分≥37.5分,存在决策延迟。多重线性回归分析显示,职业状态、糖尿病病程、家庭关怀度和焦虑抑郁是糖尿病足患者截肢决策困境的影响因素(P<0.05)。结论糖尿病足患者在截肢决策过程中面临一定的困境。临床医护人员应合理评估患者职业状况、疾病病程、家庭关怀度和患者心理状态,制订个性化的决策支持策略,以提高决策质量,防止决策延迟导致的病情变化。ObjectiveTo explore the current situation and influencing factors of amputation decision-making dilemma of diabetic foot patients.MethodsFrom July to December 2023,200 patients with diabetic foot in the Tianjin Medical University General Hospital and Tianjin Medical University Chu Hsien-I Memorial Hospital were selected as study subjects by convenience sampling.General Information Questionnaire,Decisional Conflict Scale(DCS),Family APGAR Index,and Hospital Anxiety and Depression Scale were used to conduct a cross-sectional survey.Pearson correlation was used to analyze the correlation between diabetic foot patients'amputation decision-making dilemma and family caring,anxiety and depression,and multiple linear regression was used to analyze the influencing factors of diabetic foot patients'amputation decision-making dilemma.ResultsA total of 200 questionnaires were distributed,and 180 valid questionnaires were collected,with a valid response rate of 90.0%(180/200).The DCS score of 180 patients with diabetic foot was(30.04±9.77),76.7%(138/180)patients scored≥25.0,and they had decision-making dilemma,and 25.0%(45/180)of patients scored≥37.5,indicating decision-making delay.Multiple linear regression analysis showed that occupational status,diabetes course,family caring,anxiety and depression were the influencing factors of amputation decision-making dilemma of diabetic foot patients(P<0.05).ConclusionsDiabetic foot patients face certain dilemmas in the process of amputation decision-making.Clinical medical and nursing staff should reasonably evaluate the patient's occupational status,disease course,family caring,and psychological state,and develop personalized decision support strategies to improve decision quality and prevent changes in the patient's condition caused by delayed decision-making.

关 键 词：糖尿病足 截肢 决策困境 问卷调查研究 影响因素 

分 类 号：R473.5[医药卫生—护理学]