心房颤动患者抗凝治疗决策冲突现状及影响因素研究

The current status and influencing factors of decisional conflict in anticoagulant therapy for patients with atrial fibrillation

目的调查房颤患者抗凝治疗决策冲突现状,并分析其影响因素。方法采用一般资料调查表、心房颤动知识问卷及决策冲突量表对219例房颤患者进行调查。结果房颤患者抗凝治疗决策冲突总分为(41.47±17.54)分,其中有33例(15.07%)患者不存在决策冲突,90例(41.10%)患者决策冲突处于中等水平,96例(43.83%)患者决策冲突水平较高,存在决策延迟情况。多元线性回归分析显示,患者的年龄、性别、婚姻状况、文化程度、合并症种类、对疾病了解程度是抗凝治疗决策冲突的影响因素(P<0.05,P<0.01)。结论房颤患者抗凝治疗决策冲突水平较高,不容忽视。决策冲突受多种因素影响,医护人员应针对影响因素制定个性化的治疗决策辅助方案,以降低患者决策冲突水平,改善医患关系,提高治疗满意度。

Objective To investigate the current status of decisional conflict in anticoagulant therapy for patients with atrial fibrillation,and to analyze its influencing factors.Methods Totally 219 patients with atrial fibrillation were investigated by using the general information questionnaire,the knowledge questionnaire for atrial fibrillation,and the Decisional Conflict Scale.Results The total score of decisional conflict in patients with atrial fibrillation treated with anticoagulant therapy was(41.47±17.54);33(15.07%)patients did not have decisional conflict,90(41.10%)patients were in the middle level of decisional conflict,and 96(43.83%)patients had higher level of decisional conflict and had delayed decisional conflict.Multiple linear regression analysis showed that age,gender,marital status,education levels,numbers of complications,and knowledge of disease were the influencing factors of decisional conflict in anticoagulant therapy(P<0.05,P<0.01).Conclusion The level of decisional conflict in anticoagulant therapy in patients with atrial fibrillant is high,which can not be ignored.Decisional conflict is influenced by many factors.Medical staff should make personalized treatment decision aids based on the influencing factors to reduce the level of decisional conflict,improve doctor-patient relationship and enhance treatment satisfaction.