某三甲儿童医院重症患儿照顾者决策疲劳现状及影响因素分析

Current situation of decision fatigue among caregivers of critically ill children in a grade-A tertiary children′s hospital and its influencing factors

目的调查某三甲儿童医院重症患儿照顾者决策疲劳现状,并分析其影响因素。方法采用便利抽样法,于2022年6月-2023年6月选取在儿童重症监护室(pediatric intensive care unit,PICU)住院治疗的118例重症患儿的照顾者作为研究对象,采用一般资料调查表、决策疲劳量表、家庭成员决策自我效能量表对其进行调查。结果该组重症患儿照顾者决策疲劳量表得分为(12.16±3.81)分,决策疲劳量表得分与家庭成员决策自我效能量表得分呈负相关(r=-0.882,P=0.012)。多元线性回归分析结果显示,重症患儿照顾者性别、患儿入住PICU天数、家庭平均月收入、决策自我效能是患儿照顾者决策疲劳的独立影响因素(R^(2)=0.952,_(△)R^(2)=0.902,F=16.819,P<0.001)。结论PICU重症患儿照顾者决策疲劳处于中等水平,医护人员应重点关注女性、家庭平均月收入低、患儿入住PICU时间长、决策自我效能水平低的患儿照顾者,及时向照顾者提供重症患儿病情、治疗方案、预后等信息,加强其心理支持,提升照顾者决策自我效能,从而降低其决策疲劳水平。

Objective To explore the current situation of decision-making fatigue among caregivers of critically ill children in the pediatric intensive care unit(PICU)of a grade-A tertiary children′s hospital and its influencing factors.Methods Totally 118 caregivers of PICU critically ill children who were hospitalized between June 2022 and June 2023 were selected,and surveyed using a general information questionnaire,the decision fatigue scale(DFS)and the family member decision self efficacy scale(FMDSES).Results The total DFS score was(12.16±3.81)points,which had a significant negative correlation with the FMDSES score(r=-0.882,P=0.012).The results of multiple linear regression analysis showed that the gender of caregivers,the number of days in PICU,the average monthly income of the family and the decision-making self-efficacy were independent influencing factors of the DFS score(R^(2)=0.952,_(△)R^(2)=0.902,F=16.819,P<0.001).Conclusion The decision-making fatigue of caregivers for critically ill children in PICU is at a moderate level.Medical staff should pay attention to female caregivers,or caregivers with lower average monthly income,longer days of PICU stay,and lower decision-making self-efficacy,so as to lower their DFS score by timely informing them of the condition,treatment and prognosis of patients.