呼吸重症监护室机械通气患者代理决策者决策冲突发生及影响因素分析  

Conflict occurrence and influencing factors among surrogate decision makers for RICU patients with mechanical ventilation

作　　者：王露梦 韩文娟 万腾飞 宋彩萍 WANG Lumeng;HAN Wenjuan;WAN Tengfei;SONG Caiping(Respiratory Intensive Care Unit,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,China;Nursing Office,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,China;Hospital Administration Office,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,China)

机构地区：[1]陆军军医大学(第三军医大学)第二附属医院呼吸科监护室,重庆 [2]陆军军医大学(第三军医大学)第二附属医院护理处,重庆 [3]陆军军医大学(第三军医大学)第二附属医院院办,重庆

出　　处：《陆军军医大学学报》2025年第9期995-1002,共8页Journal of Army Medical University

基　　金：重庆英才创新领军人才项目(医学领域)(CQYC20200303156)。

摘　　要：目的调查呼吸重症监护室(respiratory intensive care unit,RICU)机械通气患者代理决策者决策冲突发生并分析其影响因素。方法采用便利抽样法,选取2024年6-12月陆军军医大学第二附属医院101名RICU的机械通气患者代理决策者为调查对象。采用一般资料表、决策准备度量表、决策冲突量表进行问卷调查;采用单因素分析、Pearson相关性分析和多元线性回归对影响因素进行分析。结果RICU机械通气患者代理决策者决策准备度总分为(64.14±22.35)分;RICU机械通气患者代理决策者决策冲突总分为(35.18±26.47)分,决策冲突发生率为69.31%。单因素分析显示,是否清楚患者预后、与患者的关系、是否知道患者关于治疗的想法、对机械通气相关信息的了解程度差异有统计学意义(P<0.05);Pearson相关性分析显示,决策准备度与决策冲突及其3个维度均呈显著负相关关系(P<0.001);多元线性回归分析结果显示,对机械通气相关信息的了解程度、决策准备度为RICU机械通气患者代理决策者决策冲突的影响因素(P<0.001)。结论RICU机械通气患者代理决策者决策冲突水平较高,且代理决策者决策冲突水平与其机械通气相关信息了解程度和决策准备度呈显著负相关。Objective To survey conflict occurrence in surrogate decision makers for respiratory intensive care unit(RICU)patients with mechanical ventilation and explore its influencing factors.Methods A total of 101 surrogate decision-makers of mechanical ventilation patients in RICU were subjected from the Second Affiliated Hospital of Army Medical University from June 2024 to December 2024 by convenience sampling.General data questionnaire,Preparation for Decision Making Scale and Decisional Conflict Scale were used to conduct questionnaire survey.One-way ANOVA,Pearson correlation analysis and multiple linear regression analysis were employed to identify the influencing factors.Results The total score of decision readiness was 64.14±22.35,the total score of decision conflict was 35.18±26.47,and the incidence of decision conflict was 69.31%in the participants.Univariate analysis showed that there were statistically differences in whether knowing about prognosis,relationship with patients,awareness of patients’ideas about treatment,and understanding of information related to mechanical ventilation among the participants(P<0.05).Pearson correlation analysis indicated that decision readiness was negatively correlated with decision conflict and its 3 dimensions(P<0.001).The results of multiple linear regression analysis revealed that understanding of information related to mechanical ventilation and decision readiness were influencing factors for the decision conflict of the participants(P<0.001).Conclusion The decision conflict level is quite higher in the surrogate decision makers for RICU patients with mechanical ventilation,and the level is negatively correlated with the understanding of mechanical ventilation related information and decision readiness.

关 键 词：呼吸重症监护室 机械通气 代理决策 决策冲突 影响因素 

分 类 号：R395.1[哲学宗教—心理学] R473.5[医药卫生—医学心理学] R605.973[医药卫生—基础医学]