脑卒中半失能老年患者康复决策体验的质性研究

A Qualitative Study on the Experience of Rehabilitation Decision-Making in Semi-disabled Elderly Patients with Stroke

目的 了解脑卒中半失能老年患者在参与康复治疗决策时的体验,为制定决策支持策略提供依据。方法 本研究为质性研究,选取31名脑卒中半失能老年患者进行半结构式访谈,根据Colaizzi七步分析法对资料进行整理。结果 共提炼出3个主题和11个亚主题,即康复决策的复杂感受(迷茫、无助感、不确定感、挫败感、对医护的信任感);面临多重决策困境(参与决策延迟、信息支持不足、经济负担重、替代决策干扰);存在多方面的决策支持需求(医护人员的专业指导、有效的决策辅助支持、完善的延续性康复体系)。结论 脑卒中半失能老年患者面临多重康复决策困境,医护人员需缓解患者负性情绪,了解其真实参与决策的意愿,给予专业指导与信息支持,进而制定科学的决策支持策略。

Objective To gain an in-depth understanding of the experiences of semi-disabled elderly patients with stroke when participating in decision-making about rehabilitation therapy,and to provide a basis for the development of decision-support strategies.Methods In this qualitative study,semi-structured in-depth interviews were conducted with 31 semi-disabled elderly patients with stroke.And the data gained were organized and analyzed according to the Colaizzi seven-step analysis method.Results A total of 3 themes and 11 sub-themes were extracted,namely,complex feelings of rehabilitation decision-making(confusion,helplessness,uncertainty,frustration,and trust in healthcare),facing multiple decision-making dilemmas(delayed participation in decision-making,insufficient information support,high economic burden,and interference from alternative decision-making),and the existence of multifaceted decision support needs(professional guidance from healthcare professionals,effective decision-aiding support,and a sound continuity of the rehabilitation system).Conclusion Semi-disabled elderly patients with stroke face multiple rehabilitation decision-making dilemmas,which requires healthcare professionals to alleviate patients'negative emotions,understand their true willingness to participate in decision-making,provide professional guidance and information support,and then develop scientific decision-support strategies.