慢性肾脏病病人透析前参与决策需求现状及影响因素

Status quo and influencing factors of needs for participation in decision-making among patients with chronic kidney disease before dialysis

目的:调查慢性肾脏病病人透析前参与决策需求现状,分析其影响因素。方法:采用病人参与医疗决策期望量表、病人积极度量表、简易疾病感知问卷对237例慢性肾脏病病人进行调查。结果:慢性肾脏病病人透析前参与医疗决策期望总分为(40.94±8.30)分,其中信息需求得分为(12.08±1.87)分,交流需求得分为(20.49±4.94)分,决策需求得分为(8.36±2.96)分;疾病感知总分为(49.97±4.09)分,病人积极度总分为(37.02±4.86)分。多元线性回归分析结果显示,疾病感知、病人积极度是信息需求的影响因素,文化程度、家庭人均月收入、疾病感知、病人积极度是交流需求的影响因素,家庭人均月收入、医保类型、疾病感知、病人积极度是决策需求的影响因素。结论:慢性肾脏病病人透析前参与决策的需求水平较高,临床医护人员应关注病人参与决策过程中的需求,促进病人充分参与决策。

Objective:To investigate status quo of needs for participation in decision-making among patients with chronic kidney disease before dialysis,and to analyze its influencing factors.Methods:A survey,involving 237 chronic kidney disease patients,was conducted by using Patients'Expectation for Participation in Decision-making scale,Patient Activation Measure(PAM),and Brief Illness Perception Questionnaire(BIPQ).Results:The total score of the expectation for participation in decision-making scale among patients with CKD before dialysis was 40.94±8.30.The scores of needs for information,communication and decision were 12.08±1.87,20.49±4.94,and 8.36±2.96,respectively.The total score of BIPQ was 49.97±4.09.The total score of PAM was 37.02±4.86.The results of multivariate linear analysis showed that illness perception and patient activation were the influencing factors of information need.Education level,per capita family monthly income,illness perception and patient activation were the influencing factors of communication need.Per capita family monthly income,type of medical insurance,illness perception and patient activation were the influencing factors of decision-making need.Conclusion:Patients with chronic kidney disease have a high level of needs for participation in decision-making before dialysis.Medical staff in clinical practice should pay attention to the needs for participation in decision-making of patients,and foster their enthusiasm on participation in decision-making.