ICU患者代理决策者决策冲突现状及影响因素分析  

Analysis of the current situation and influencing factors of decision-making conflicts among surrogate decision-makers for ICU patients

作　　者：贾秀丽[1] 张艳洪 尤琦[1] 张丽敏[1] Jia Xiuli;Zhang Yanhong;You Qi;Zhang Limin(Intensive Care Unit,Harbin Medical University Cancer Hospital,Harbin 150040,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院重症医学科,黑龙江哈尔滨150040

出　　处：《护理学杂志》2024年第22期92-97,共6页Journal of Nursing Science

基　　金：哈尔滨医科大学附属肿瘤医院海燕科研基金(JJZD2023-05)。

摘　　要：目的调查ICU患者代理决策者决策冲突现状并分析其影响因素。方法采用便利抽样法,选取390名ICU患者代理决策者为研究对象。采用一般资料调查表、决策冲突量表、决策准备量表、决策参与量表及维克森林医师信任量表进行调查。结果ICU患者代理决策者决策冲突得分为(43.33±7.25)分,决策准备得分为(30.62±6.81)分,决策参与得分为(64.46±10.37)分,医师信任得分为(37.95±6.35)分;Pearson相关分析显示,ICU患者代理决策者决策冲突总分与决策准备、决策参与及医师信任总分均呈负相关(均P<0.05);多元线性回归分析显示,是否了解该疾病、代理决策者年龄、决策参与、决策准备、医师信任是ICU代理决策者决策冲突得分的主要影响因素(均P<0.05),可解释总变异的43.1%。结论ICU患者代理决策者决策冲突处于较高水平。建议护理管理者应对决策冲突水平较高的代理决策者进行干预,以减轻其决策困境,提高决策质量,实现患者利益最大化。Objective To investigate the current situation of decision-making conflicts among surrogate decision-makers for ICU patient and analyze its influencing factors.Methods A total of 390 surrogate decision-makers for ICU patient were chosen as the research participants by using the convenience sampling method.The survey was conducted with the general information questionnaire,the Decision Conflict Scale(DCS),the Preparation for Decision Making Scale(Prep-DMS),the Decisional Engagement Scale(DES-10),and the Wake Forest Physician Trust Scale(WFPTS).Results The decision conflict score of the surrogate decision-makers was(43.33±7.25),decision preparation score was(30.62±6.81),decision participation score was(64.46±10.37),and physician trust score was(37.95±6.35).Pearson correlation analysis showed that the total decision conflict score of the surrogate decision-makers and the total score of decision preparation,decision participation,and of physician trust were negatively correlated(all P<0.05).Multiple linear regression analysis showed that knowledge of the disease,age of the surrogate decision-maker,decision participation,decision preparation,and physician trust were the main influencing factors of surrogate decision-makers'decision conflict scores(all P<0.05),explaining 43.1%of the total variation.Conclusion Decision conflict among surrogate decision-makers for ICU patients is at a high level.It is recommended that nursing managers should intervene with the surrogate decision-makers who have higher levels of decisional conflict to alleviate their decision-making dilemma,improve the quality of decision-making,and maximize patient benefits.

关 键 词：重症监护病房 代理决策者 决策冲突 决策准备 决策参与 医师信任 患者利益 影响因素 

分 类 号：R47[医药卫生—护理学]