连续性肾脏替代治疗患者家属决策后悔现状及影响因素分析

Decision regret and its determinants in family members of patients on continuous renal replacement therapy

目的了解连续性肾脏替代治疗患者家属决策后悔现状及影响因素,为针对性干预提供参考。方法采用一般资料调查表,决策后悔量表、决策参与量表、决策冲突量表、决策准备度量表对102名连续性肾脏替代治疗患者家属进行问卷调查。结果患者家属决策后悔得分为36.86±13.98,83.35%的家属决策后悔水平较高;决策类型中78人为被动型,14人为主动型,10人属于合作型;决策准备度得分为51.57±15.43;决策冲突得分27.63±9.47;决策准备度与决策后悔呈负相关,决策冲突与决策后悔呈正相关(均P<0.05);多元逐步线性回归分析显示,性别、照护经历、对连续性肾脏替代治疗了解程度、决策类型、决策准备度是患者家属决策后悔的重要影响因素(均P<0.05)。结论连续性肾脏替代治疗患者家属大部分存在决策后悔且水平较高,受多种因素影响;医护人员可针对男性、对连续性肾脏替代治疗缺乏了解、被动性决策及准备度较低的家属实施干预,以降低其决策后悔程度。

Objective To explore the status quo of decision regret in family members of patients on continuous renal replacement therapy(CRRT)and analyze its influencing factors,so as to provide reference for targeted intervention.Methods Totally,102 family members of patients undergoing CRRT completed a battery of questionnaires,including a general information questionnaire,the Decision Regret Scale,Control Preferences Scale,Decisional Conflict Scale and Preparation for Decision Making Scale.Results The sample scored 36.86±13.98 on decision regret,among whom 83.35%had a high level of decision regret.Of the 102 participants,78 preferred a passive role,14 preferred an active role,and 10 preferred to share responsibility with the doctor.The preparation for decision making score was 51.57±15.43,and the decisional conflict score was 27.63±9.47.Decision regret was positively correlated with decisional conflict,whereas inversely correlated with preparation for decision making(both P<0.05).Multiple linear regression analysis showed that sex,caregiving experience,CRRT knowledge,control preferences and preparation for decision making were factors influencing decision regret of family members(all P<0.05).Conclusion Decision regret in family members of patients undergoing CRRT is at a relatively high level and influenced by various factors.Interventions should be provided for those who are male,lack knowledge about CRRT,prefer a passive role in decision-making,or who are not well prepared for decision-making,to reduce their decision regret.