共享决策干预方案在稳定性冠心病决策困境患者中的应用研究

Application of shared decision making-based intervention in stable coronary artery disease patients with decisional conflict

目的探讨共享决策干预方案对稳定性冠心病患者决策困境和健康素养的影响。方法将86例稳定性冠心病患者按照入组时间分为试验组和对照组,每组43例。对照组给予常规护理,试验组在常规护理基础上实施共享决策干预方案。分别于干预前和干预1个月后,采用决策冲突量表(DCS)和健康素养量表(HeLMS)评价干预效果。结果干预前2组患者DCS量表和HeLMS量表各维度得分及总分比较差异无统计学意义(P>0.05);干预后试验组信息和价值观、决策不确定性得分及DCS总分分别为(6.95±2.13)、(3.44±1.18)、(20.95±3.99)分,明显低于对照组的(8.77±2.33)、(4.95±1.46)、(25.56±4.03)分;试验组信息获取能力、交流互动能力、改善健康意愿、经济支持意愿等维度得分及HeLMS总分分别为(36.77±4.85)、(35.74±4.58)、(15.07±1.55)、(6.53±1.76)、(94.12±6.44)分,明显高于对照组的(34.37±5.84)、(33.19±5.90)、(14.23±1.43)、(5.81±1.29)、(87.60±9.18)分,差异有统计学意义(t值为2.070~5.321,P<0.05)。结论共享决策干预方案能有效改善稳定性冠心病患者决策困境,提高健康素养水平。

Object To explore the effects of shared decision making-based intervention on decisional conflict and health literacy in stable coronary artery disease patients.Methods A total of 86 stable coronary artery disease patients were divided into experimental group and control group according to the admission order,with 43 cases in each group.The patients in the control group recieved routine nursing,basis on this,the experimental group carried out shared decision making program.Before and after 1 month of intervention,the effects was assessed by Decisional conflict scale(DCS)and Health literacy management scale(HeLMS),respectively.Results Before intervention,there was no significant difference in DCS and HeLMS scores between two group(P>0.05).After intervention,the information&values,decision uncertainty and total DCS scores were(6.95±2.13)pionts,(3.44±1.18)pionts and(20.95±3.99)pionts,significantly lower than in the control group(8.77±2.33)pionts,(4.95±1.46)pionts,(25.56±4.03)pionts;the information acquisition ability,interaction ability,willingness to improve health,willingness of financial support and total HeLMS scores were(36.77±4.85)pionts,(35.74±4.58)pionts,(15.07±1.55)pionts,(6.53±1.76)pionts,(94.12±6.44)pionts,significantly higher than in the control group[(34.37±5.84)pionts,(33.19±5.90)pionts,(14.23±1.43)pionts,(5.81±1.29)pionts,(87.60±9.18)pionts],the difference was statistically significant(t values were 2.070-5.321,P<0.05).Conclusion Shared decision making can effectively alleviate decisional conflict and improve health literacy of patients with stable coronary artery disease.