决策辅助工具在妇科恶性肿瘤患者静脉化疗通路选择中的应用  

Application of decision support tools in intravenous chemotherapy pathways for patients with gynecological malignant tumors

作　　者：赵益 林梦 王思浓 张慧 ZHAO Yi;LIN Meng;WANG Sinong;ZHANG Hui(International Medical Department,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing,100730,China)

机构地区：[1]中国医学科学院北京协和医院国际医疗部,北京市100730

出　　处：《中国护理管理》2024年第12期1798-1803,共6页Chinese Nursing Management

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-130);北京协和医院护理科研课题(XHHLKY202212);北京协和医院护理科研课题(XHHLKY202311)。

摘　　要：目的:构建妇科恶性肿瘤患者静脉化疗决策辅助工具,并评价其应用情况,为开发决策辅助工具提供参考。方法:基于渥太华决策支持框架,采用混合性研究方法构建妇科恶性肿瘤患者化疗静脉通路决策辅助工具;采用便利抽样的方法,选择2021年10月至2022年9月北京市某三级甲等医院收治的144例妇科恶性肿瘤患者为研究对象进行工具的临床应用,随机分为对照组与实验组,利用患者参与治疗决策意愿与实际问卷、决策困境量表等进行效果评价。结果:构建的决策辅助工具包括问题清单、静脉化疗通路装置选择表和决策辅助手册。应用后发现实验组患者实际参与程度、决策满意度、中心静脉置管率均优于对照组(P<0.05),决策困境程度低于对照组(P<0.05)。结论:决策辅助工具设计科学且实用,能够促进患者参与临床决策,降低决策困境。Objective:To construct a decision-making aid tool for intravenous chemotherapy in patients with gynecologic malignant tumor and evaluate its effects,so as to provide reference for developing decision-making aids.Methods:Based on the Ottawa Decision Support Framework,a mixed research method was used to construct a decisionmaking aid tool for intravenous access to chemotherapy in patients with gynecological malignant tumor.Totally 144 patients with gynecological malignant tumors admitted to a tertiary grade A hospital in Beijing from October 2021 to September 2022 were selected by convenience sampling method for the clinical application of the tool,and they were randomly divided into control group and experimental group.The patients'willingness to participate in treatment decision-making and actual questionnaires,decision-making dilemma scale and other indicators were used for evaluation.Results:The decision-making support tools included a list of questions,a selection table of intravenous chemotherapy access devices,and a decisionmaking assistance manual.The actual participation,decision-making satisfaction and central venous catheterization rate of the experimental group were better than those of the control group(P<0.05),and the degree of decision-making dilemma was lower than that of the control group after the application of decision-making aid tool(P<0.05).Conclusion:The decisionmaking aid tool is scientific and practical,which can promote patients'participation in clinical decision-making and reduce decision-making dilemmas.

关 键 词：决策辅助工具 肿瘤 化疗 静脉通路 渥太华决策支持框架 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]