在中风住院患者出院规划期间,由结果信息支持的共享决策
J C M Prick1,2, M V Verschueren3, I A Deijle4
1Department of Neurology, OLVG, Amsterdam, the Netherlands.
Neurology. Clinical practice
|December 29, 2025
概括
该SHOUT-STROKE研究发现,共享决策 (SDM) 干预并没有显著改善中风患者在出院期间的结果. 虽然受到赞赏,但该干预措施需要优化,以实现更大的患者赋权和改进决策过程.
科学领域:
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
- 患者参与 患者参与
背景情况:
- 卒中患者在出院计划期间经常面临复杂的决策.
- 共享决策 (SDM) 旨在使患者更积极地参与他们的护理.
- 在SHOUT-STROKE研究中,研究了对中风患者的SDM干预.
研究的目的:
- 评估SDM干预对决策,健康和过程结果的影响.
- 评估患者决策辅助 (PtDA) 与结果信息相结合的有效性.
- 分析SDM培训对中风护理医疗保健专业人员的实施情况.
主要方法:
- 在7家荷兰医院进行前性多重中断时间序列研究 (2019年11月 - 2022年3月).
- 阶段性方法:预实施 (标准护理),过渡 (PtDA整合),后实施 (新工作流).
- 分段自回归和元分析用于估计对SDM-Q-9分数和二次结果的影响.
主要成果:
- 在SDM-Q-9分数中没有显著的整体改善 (效果 -4.5分;95% CI -11.3至2.2).
- 在二次决策或健康结果方面没有发现显著差异.
- 在2家医院,患者知识得分显著提高;对于大多数用户来说,PtDA是有用的.
结论:
- SDM干预得到了患者的好评,但并没有显著提高SDM水平.
- 在一些中心改善的患者知识不足以充分参与SDM.
- 优化实施过程对于在中风护理中实现更具影响力的SDM结果至关重要.
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