基于患者价值的远程医疗体系构建对肝癌患者行为意向及决策参与满意度的影响

The effect of the construction of telemedicine system on the basis of patient value on the behavioral intention and decision-making participation satisfaction of patients with liver cancer

目的:研究基于患者价值的远程医疗体系构建对肝癌患者行为意向及决策参与满意度影响。方法:选取医院收治的71例肝癌患者,按照基于患者价值的远程医疗体系构建前后顺序,将2017年3月至2018年3月收治的36例肝癌患者纳入对照组,2018年4月至2019年3月收治的35例肝癌患者纳入观察组。对照组采用常规的医疗体系管理;观察组构建并实施基于患者价值的远程医疗体系管理;采用3个量表对比分析两组肝癌患者的医疗行为意向、安全行为意向以及决策参与满意度。结果:观察组医疗行为意向量表中共同参与意愿和共同参与行为评分均高于对照组,两组比较差异有统计学意义(t=5.231,t=4.587;P<0.05);观察组在安全行为意向量表能主动提醒、能主动并反复提问和否认是医务人员自身事情的患者比例高于对照组,两组比较差异有统计学意义(x^2=6.365,x^2=7.227,x2=10.745;P<0.05);观察组决策参与满意度量表中信息、交流协商、决策和总满意度及信心评分均高于对照组,两组比较差异有统计学意义(t=5.231,t=4.587,t=6.369,t=3.224;P<0.05)。结论:基于患者价值的远程医疗体系的构建能明显提高肝癌患者的医疗及安全行为意向,提高患者的决策参与满意度。

Objective:To explore the effect of the telemedicine system based on patient value on the behavioral intention and decision-making participation satisfaction of patients with liver cancer.Methods:A total of 71 patients with liver cancer who received treatment in hospital were selected.As sequence before and after construction of telemedicine system on the basis of patients value,those who were treated during March 2017 and March 2018 were divided in control group(36 cases),and those who were treated since March 2019 were divided in observation group(35 cases).The control group followed the conventional medical system management,and the observation group followed the telemedicine system management on the basis of patient value.The medical behavior intention,safety behavior intention and decision-making participation satisfaction of the two groups were compared and analyzed by 3 scales.Results:The scores of the co-participation willingness and the co-participation behavior in medical behavioral intention scale of observation group were significantly higher than those of control group(t=5.231,t=4.587,P<0.05).The proportions of patients who can be reminded proactively,and be proactively and repeatedly asked,and that whether it is the own business of medical staffs in safety behavior intention scale of observation group were significantly higher than that of control group(x^2=6.365,x^2=7.227,x^2=10.745,P<0.05).And the information,communication and consultation,decision-making and overall satisfaction,and confidence scores in decision-making participation satisfaction scale of observation group were significantly higher than those of control group(t=5.231,t=4.587,t=6.369,t=3.224,P<0.05).Conclusion:The construction of telemedicine system on the basis of patient value can significantly improve the intention of medical treatment and safety behavior of patients with liver cancer,and improve the satisfaction of patients for decision-making participation.