在接受置换治疗的患者中,共享决策过程及其影响因素:一种定性描述性研究
Youying Zhang1, Hongmei Peng1,2, Yang Li1
1Department of Nephrology, Chongqing Key Laboratory of Prevention and Treatment of Kidney Disease, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China.
BMC medical informatics and decision making
|November 25, 2025
概括
患有末期脏病 (ESKD) 的患者面临关于脏替代疗法的复杂决策. 了解症状感知,信息困境和影响因素对于有效的共享决策至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗保健决策 - - 医疗保健决策
- 以患者为中心的护理
背景情况:
- 末期病 (ESKD) 患者在选择替代疗法时面临挑战,因为信息和治疗途径复杂.
- 以人为中心的护理强调了患者的倡导和权利,推动了关于患者和医生的合作和共同决策的讨论.
- 对ESKD患者透析方式决策的研究正在增加,但需要特定的上下文概念框架.
研究的目的:
- 研究中国ESKD患者的置换疗法决策过程.
- 在第三级医院脏病科内确定影响这些决定的因素.
- 为ESKD管理中更广泛的共享决策模式做出贡献.
主要方法:
- 涉及12名ESKD患者进行面对面,半结构面试的定性研究.
- 采访数据的诱导性主题分析,以确定主题和模式.
- 使用NVIVO 12.0软件进行数据编码,以进行深入的解释.
主要成果:
- 出现了三个主要主题:症状感知 (先决条件),信息和沟通困境以及决策行为.
- 八个子主题详细介绍了身体/心理症状感知,信息/沟通挑战以及个人,家庭,社会和治疗影响.
- 决策是一个多阶段的过程,受到一系列因素的影响.
结论:
- 通过症状感知,信息/沟通挑战和多方面的行为影响,ESKD患者对置换疗法的决策进展.
- 这些发现为支持患者价值观和经验的临床实践提供了理论基础.
- 开发患者决策辅助工具和利用信息技术可以增强决策支持和信息传递.
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