以护士为"决策教练"的共享决策干预在膀胱癌患者围手术期中的应用  

Effectiveness of a shared decision-making intervention with nurses as"decision coaches"in the perioperative period for bladder cancer patients

作　　者：郭静 王新丽 方晓霞 荆中 任胜杰 Guo Jing;Wang Xinli;Fang Xiaoxia;Jing Zhong;Ren Shengjie(First Department of Urology Surgery,Xinxiang Central Hospital&the Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China;Nursing Department,Xinxiang Central Hospital&the Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院、新乡医学院第四临床学院泌尿外科一,新乡453000 [2]新乡市中心医院新乡医学院第四临床学院护理部,新乡453000

出　　处：《中华现代护理杂志》2025年第10期1346-1351,共6页Chinese Journal of Modern Nursing

摘　　要：目的探讨以护士为"决策教练"的共享决策干预在膀胱癌手术患者围手术期决策管理中的应用。方法采用便利抽样法,于2023年3月—2024年2月选择在新乡市中心医院泌尿外科住院行手术治疗的152例膀胱癌患者,采用随机数字表法分为对照组和观察组,各76例。对照组实施常规膀胱癌手术决策管理,观察组在此基础上实施以护士为"决策教练"的共享决策干预,干预周期均为术前1周。比较两组患者干预前后决策冲突量表(DCS)、决策准备度量表(PrepDM)、决策参与满意度量表、决策后悔量表(DRS)得分的差异。结果最终对照组74例、观察组75例患者完成研究。干预后,观察组的DCS得分低于对照组及干预前,差异均有统计学意义(均P<0.05);干预后,观察组的PrepDM得分高于对照组及干预前,差异均有统计学意义(均P<0.05)。术后1周,观察组的决策参与满意度得分高于对照组,DRS得分低于对照组,差异均有统计学意义(均P<0.05)。结论膀胱癌患者术前接受以护士为"决策教练"的共享决策干预可以有效降低术前决策冲突,提高术前决策准备度和决策参与满意度,减少患者术后的决策后悔程度。Objective To explore the effectiveness of shared decision-making intervention with nurses as"decision coaches"in perioperative decision management of bladder cancer patients.Methods From March 2023 to February 2024,152 bladder cancer patients in the Department of Urology Surgery of Xinxiang Central Hospital for surgical treatment were selected by convenience sampling.The patients were divided into control group and observation group of 76 cases each using the randomized numerical table method.Control group implemented conventional bladder cancer surgical decision management,and observation group implemented a shared decision-making intervention with nurses as"decision coaches"on this basis,and the intervention period was one week before surgery.Decisional Conflict Scale(DCS),Preparation Decision Making(PrepDM),Patients Satisfaction with Participation in Medical Decision-making Scale,and Decision Regret Scale(DRS)scores were compared between the two groups of patients before and after intervention.Results Finally 74 patients in control group and 75 patients in observation group completed the study.After the intervention,the DCS scores of observation group were lower than those of control group and before the intervention,and the differences were statistically significant(all P<0.05).After the intervention,the PrepDM scores of observation group were higher than those of control group and before the intervention,and the differences were statistically significant(all P<0.05).One week after surgery,observation group had higher decision-making participation satisfaction scores and lower DRS scores than control group,and the differences were statistically significant(all P<0.05).Conclusions Preoperative shared decision-making interventions with nurses as"decision coaches"in bladder cancer patients can effectively reduce preoperative decision conflicts,increase preoperative decision readiness and participation satisfaction with decision-making,and decrease patients'postoperative decision regret.

关 键 词：膀胱肿瘤 护士 共享决策 决策教练 决策管理 术前 

分 类 号：R47[医药卫生—护理学]