徐天颖,傅利勤,吴菁.膝关节置换患者的手术决策参与及其影响因素的调查研究[J].上海护理,2021,21(1):
膝关节置换患者的手术决策参与及其影响因素的调查研究
Investigation in patient Participation in surgical Decision-making of knee joint replacement
DOI:
中文关键词:  膝关节置换术  决策参与  医患信任
英文关键词:knee joint replacement  patient participation  decision-making  patient trust in doctor
基金项目:国家自然科学基金项目(青年项目)
作者单位E-mail
徐天颖 上海交通大学医学院附属新华医院 849430469@qq.com 
傅利勤 海军军医大学附属长海医院关节外科  
吴菁* 海军军医大学护理系 qingqing20030511@163.com 
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中文摘要:
      摘要:目的 描述膝关节置换患者参与医疗决策的偏好及实际参与程度现状;探讨影响膝关节置换患者参与度的相关因素;分析膝关节置换患者的决策参与和医患信任之间的关系。方法 2018年10月至2019年4月调查120例某三甲医院骨关节科的膝关节置换术术后患者,应用一般资料调查表、决策参与偏好问卷、维克森林医师信任量表等对患者进行现状评估。结果 膝关节置换患者的决策参与偏好中,合作型占74.2%(89)、被动型占19.2%(23)、主动型占6.7%(8);实际决策参与的类型为合作型占72.5%(87)、被动型占21.7%(26)、主动型占5.8%(7);膝关节置换患者的决策参与偏好和实际决策参与程度分布存在显著统计学差异(χ2 = 32.940,P < 0.001)。不同决策参与类型的患者对“医师信任”得分虽然略有高低,其中被动型的患者信任度最高,为(4.688 ± 0.322)分,其次为合作型的患者为(4.530 ± 0.483)分,主动型的患者信任度最差,为(4.386 ± 0.582)分,但无统计学差异(P > 0.05)。 结论 膝关节置换患者更倾向于合作型的医疗决策参与;膝关节置换患者的医患信任度处于较高水平;膝关节置换患者医疗决策参与偏好在实际决策中未得到较好满足。
英文摘要:
      Abstract: Objective To describe the present situation of the preferences and actual degree of patient participation in surgical decision-making of knee joint replacement and investigate the influencing factors. Methods From October 2018 to April 2019, 120 patients were investigated after knee arthroplasty in a Grade-A hospital. The patients were evaluated using the general data questionnaire, Control Preference Scale and Wake Forest Physician Trust Scale. Results 74.2% of the participants preferred to the cooperation style, 19.2% passive and 6.7% active in decision making. In reality, 72.5% of patients took the cooperation style, 21.7 % passive and 5.8% active. There was significant difference in the distribution of decision-making participation preference and actual decision-making participation degree in patients with knee joint replacement(χ2=32.940,P < 0.001). Although patients’ trust in doctors were different in different participation style, there was no significant difference (P > 0.05). Conclusion: Patients with knee replacement are more likely to cooperatively participate in medical decision-making. Patients with knee replacement have a high level of trust in doctors. The medical decision participation preference of knee joint replacement patients is not fulfilled in actual decision making.
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