126例门诊慢性伤口患者参与治疗决策的现状调查

Participation in Treatment Decision-making of Patients with Chronic Wounds in Outpatient:A 126-case Study

目的了解慢性伤口患者参与治疗决策的现状。方法采用便利抽样法,于2016年6月—2016年9月抽取126例慢性伤口患者,使用一般资料问卷、患者参与治疗决策问卷对其进行调查。结果慢性伤口患者参与治疗决策的参与态度维度均分为(1.34±0.19)分,实际参与度维度均分为(2.06±0.31)分。其中,参与态度积极者95例(75.4%),实际参与度低者117例(92.9%)。参与态度得分最低即参与态度积极的3个条目为:我参与治疗方案的讨论;在有关我治疗的问题上,医生护士能听取我的意见;在开始治疗前征询我的意见。实际参与度得分最低即实际参与度高的3个条目为:医生决定我的治疗方案;在开始治疗前征询我的意见;我参与治疗方案的讨论。结论慢性伤口患者参与治疗决策的态度较为积极,但实际参与度较低。患者主要以合作、主动决策模式参与到治疗方案形成的过程中,而以医生为主导的被动决策模式决定最终治疗方案。建议医护人员关注患者参与治疗决策的积极性,分阶段评估患者期望的决策方式,同时提供给患者必要的信息支持,尽可能的多提供给患者参与和治疗决策讨论的机会,听取患者意见,避免过多干预、替代患者参与治疗决策,提高患者的治疗信心和就医满意度。

Objective To understand the participation in treatment decision-making of patients with chronic wound.Methods From June to September 2016,126 patients with chronic wounds were investigated using general information questionnaire and patients ＇participation in treatment decision-making questionnaire.Results The average score of participating attitude of patients toward treatment decision-making was 1.34 ±0.19,and that of actual participation was 2.06 ±0.31.Of the total,95 patients accounted for75.4% participated into the treatment decision-making actively and 117 patients accounted for 92.9 % were with low actual participation.Three items with patients ＇ active participation in the dimension of participating attitude were patients ＇ participation in the discussion of their treatment,acceptance of patients ＇ suggestion from medical staff and consultation of patients ＇ suggestion before the treatment.Three items with patients ＇ active participation in the dimension of actual participation were leading roles of doctor in patients＇ treatment decision-making,consultation of patients＇ suggestion before the treatment and patients＇ participation in the discussion of their treatment.Conclusion Patients with chronic wound involve in treatment decision-making positively,but they actually seldom participate in the decision-making.The patients are mainly involved in the process of treatment planning,but the final treatment plan is made dominantly by doctors.Medical staff should not ignore patients ＇ enthusiasm of participation into the treatment decision-making.Taking patients＇ expected decision-making into consideration in different treatment phase,more information support and more opportunities to involve into the treatment decision-making are beneficial to improving patients ＇ confidence in treatment and their medical satisfaction.