原发性开角型青光眼患者决策辅助方案的构建及应用

目的探讨决策辅助方案在原发性开角型青光眼患者中的应用效果。方法将100例原发性开角型青光眼患者按住院时间分为对照组与观察组各50例;对照组行常规护理,观察组在常规护理基础上实施决策辅助方案。分别于干预后(出院前)、出院后1、3个月评价干预效果。结果干预后观察组决策困境得分显著低于对照组,决策准备得分显著高于对照组,出院后1、3个月药物依从性得分显著高于对照组,出院后3个月目标眼压达标率显著高于对照组(均P<0.05)。结论决策辅助方案的应用可有效降低原发性开角型青光眼患者决策困境水平,提高决策准备度,增强用药依从性,从而提高目标眼压达标率。

基于问题提示清单和个人决策指导的急性阑尾炎患儿决策辅助干预

目的 探讨基于问题提示清单和个人决策指导的决策辅助干预在急性阑尾炎患儿治疗决策中的应用效果。方法 便利选取急性阑尾炎患儿监护人为研究对象,按照患儿就诊时间分为对照组和干预组各49人。对照组实施常规术前谈话和健康教育,干预组在对照组基础上实施基于问题提示清单和个人决策指导的决策辅助干预。比较两组决策困境、决策准备度和决策参与满意度。结果 干预后,干预组患儿监护人决策困境总分显著低于对照组,决策准备度及决策参与满意度总分显著高于对照组(均P<0.05)。结论 基于问题提示清单和个人决策指导的决策辅助干预,能够降低急性阑尾炎患儿监护人决策困境,提高其决策准备度和决策参与满意度。

心房颤动患者抗凝治疗决策冲突现状及影响因素研究

目的调查房颤患者抗凝治疗决策冲突现状,并分析其影响因素。方法采用一般资料调查表、心房颤动知识问卷及决策冲突量表对219例房颤患者进行调查。结果房颤患者抗凝治疗决策冲突总分为(41.47±17.54)分,其中有33例(15.07%)患者不存在决策冲突,90例(41.10%)患者决策冲突处于中等水平,96例(43.83%)患者决策冲突水平较高,存在决策延迟情况。多元线性回归分析显示,患者的年龄、性别、婚姻状况、文化程度、合并症种类、对疾病了解程度是抗凝治疗决策冲突的影响因素(P<0.05,P<0.01)。结论房颤患者抗凝治疗决策冲突水平较高,不容忽视。决策冲突受多种因素影响,医护人员应针对影响因素制定个性化的治疗决策辅助方案,以降低患者决策冲突水平,改善医患关系,提高治疗满意度。

Role of decision aids in orthopaedic surgery

Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction.