决策辅助在胰十二指肠术后患者中的应用效果

Application Effect of Decision Aid in Patients After Pancreaticoduodenectomy

目的:探讨决策辅助在胰十二指肠术后患者中的应用效果。方法:选取2021年9月—2022年5月在青岛大学附属医院肝胆胰外科行胰十二指肠切除术的86例患者作为研究对象,按照入院时的病区不同分为对照组与干预组。对照组给予常规护理,干预组在对照组基础上给予决策辅助干预方案。比较两组术后胃肠功能恢复情况、不良反应发生情况、焦虑抑郁情况、治疗决策参与程度与决策满意度。结果:干预组肠鸣音恢复时间、首次排气及排便时间均短于对照组,差异有统计学意义(P<0.05)。干预组术后腹胀、胃排空障碍发生率低于对照组,差异有统计学意义(P<0.05);两组术后恶心呕吐发生率比较,差异无统计学意义(P>0.05)。干预组焦虑评分、焦虑抑郁总分均低于对照组,差异有统计学意义(P<0.05);两组抑郁评分比较,差异无统计学意义(P>0.05)。干预组治疗决策参与程度评分低于对照组,决策满意度评分高于对照组,差异有统计学意义(P<0.05)。结论:决策辅助可引导患者积极参与临床决策,提高治疗依从性,提高决策满意度,促进胰十二指肠术后患者胃肠功能恢复。

Objective:To explore the application effect of decision aid in patients after pancreaticoduodenectomy.Methods:A total of 86 patients who underwent pancreaticoduodenectomy in the Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hospital of Qingdao University from September 2021 to May 2022 were selected as the study subjects.They were divided into control group and intervention group according to the different ward areas at admission.The control group was given routine nursing,and the intervention group was given decision aid intervention program on basis of control group.The postoperative gastrointestinal function recovery,occurrence of adverse reactions,anxiety and depression,participation degree in treatment decision-making and decision-making satisfaction were compared between the two groups.Results:The time of bowel sound recovery,first exhaust and defecation in the intervention group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative abdominal distension and gastric emptying disorder in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative nausea and vomiting between the two groups(P>0.05).The anxiety score and the total score of anxiety and depression in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in depression score between the two groups(P>0.05).Decision-making participation degree score in the intervention group was lower than that in the control group,the decision-making satisfaction score in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Decision aid guides patients to participate in clinical decision-making,enhances treatment compliance,improves decision-making satisfaction,and promotes the recovery of gastrointestinal function after pancreaticoduodenectomy.