缺血性脑卒中患者预立医疗照护计划准备度及其影响因素的研究

Investigation on the readiness for advance care planning and its influencing factors in patients with ischemic stroke

目的:了解缺血性脑卒中患者预立医疗照护计划(ACP)准备度现状及其影响因素。方法:采用ACP准备度量表、希望水平量表、社会支持度量表、生活质量量表等调查工具对在安徽医科大学附属宿州医院选取的150例缺血性脑卒中患者进行调查。采用多元线性回归分析ACP准备度的影响因素。结果:150例缺血性脑卒中患者ACP准备度得分为(63.31±13.08)分,其中ACP态度得分(27.91±9.03)分、ACP信念得分(15.89±6.50)分、ACP动机得分(19.51±6.83)分。多元线性回归分析发现影响缺血性脑卒中患者ACP准备度的因素有疾病持续时间、对当前与未来的态度、主观支持、客观支持、生活质量。结论:缺血性脑卒中患者ACP准备度处于中等偏下水平,提示大部分缺血性脑卒中患者并未做好实施ACP的准备。针对农村居民、低文化程度、无子女、疾病持续时间长、无被抢救经历、对死亡的态度回避、对当前与未来的态度差、社会支持水平低和生活质量差的人群进行宣传和干预,有利于在缺血性脑卒中患者中推行ACP,从而提高医疗资源的合理利用。

Objective:To understand the current status of readiness for advance care planning(ACP)and its influencing factors in patients with ischemic stroke.Methods:A survey was conducted in 150 patients with ischemic stroke in our hospital using Advance Care Planning Readiness Scale,Hope Scale,Social Support Scale,and Quality of Life Scale.Multiple linear regression model was used to analyze the factors affecting readiness for ACP.Results:The total score on readiness was(63.31±13.08)points for the 150 patients of ischemic stroke,in which scoring on the attitude,belief,and motivation in ACP was(27.91±9.03)points,(15.89±6.50)points,and(19.51±6.83)points,respectively.Multiple linear regression analysis showed that the factors affecting ACP readiness in patients of ischemic stroke were associated with duration of the disease,current and future attitudes,subjective support,objective support,and quality of life.Conclusion:The ACP readiness in patients of ischemic stroke remains at a moderately lower level,suggesting that most of them are beyond ready to implement ACP.Propaganda and intervention should be aimed at rural residents,and subjects with lower education level,no children,long duration of illness,no experience of being rescued,avoidance of attitude towards death,poor attitude towards current and future,low level of social support and poor quality of life.These measures can be conducive to implementation of ACP in patients with ischemic stroke,thereby improving the rational use of medical resources.