肾移植受者手术决策参与满意度的调查研究

doi:10.3761/j.issn.0254-1769.2021.09.010

摘要/Abstract

摘要：

目的了解肾移植受者手术决策参与满意度现状并分析其影响因素。方法 2020年11月—2021年1月,采用便利抽样法选取成都市某三级甲等综合医院器官移植门诊随访的272例肾移植受者进行调查。采用肾移植受者一般资料调查表、决策期待量表、患者家属手术决策参与程度调查表、患者对医疗决策知情程度调查表、患者对医疗决策参与的满意度调查问卷,对肾移植受者进行调查。结果肾移植受者手术决策参与满意度总分为（78.84±11.47）分,其中,信息维度得分为（70.70±17.14）分,交流协商维度得分为（79.69±13.75）分,决策维度得分为（80.73±12.47）分,总满意度及信心维度得分为（84.25±12.67）分。年龄、家属参与手术决策的程度、医疗费用支付方式以及患者对于手术决策知情程度等对肾移植受者手术决策参与满意度有影响（均P<0.05）。多元线性回归分析显示,患者对于手术决策知情程度是肾移植受者手术决策参与满意度的独立影响因素（P<0.001）。结论肾移植受者手术决策参与满意度水平有待提高,对手术决策的知情程度是影响其参与满意度的主要因素。医护人员应结合肾移植受者年龄和家属参与程度,对其手术决策知情情况进行综合评估,制订个体化决策辅助干预措施。

关键词: 肾移植受者, 决策知情程度, 手术决策参与满意度, 护理

Abstract:

Objective To understand the status of the participating satisfaction of kidney transplantation recipients in surgical decision-making and to analyze the influencing factors. Methods With convenient sampling,a total of 272 patients after renal transplantation in the organ transplantation center of a tertiary hospital from November 2020 to January 2021 in Chengdu were investigated by the general information questionnaire for kidney transplantation recipients,the decision-making expectation scale,the questionnaire on the degree of participation of the patient’s family in surgical decision-making,the questionnaire on the degree of patient’s knowledge of surgical decision-making,and the questionnaire on the satisfaction of the patient’s participation in surgical decision-making. Results The total score of patients’ satisfaction with treatment decision-making participation after renal transplantation was（78.84±11.47）,in which the information dimension was（70.70 ±17.14）,the communication and negotiation dimension was （79.69±13.75）,the decision-making dimension was （80.73 ±12.47）,and the total satisfac-tion and confidence dimension were（84.25±12.67）. Age,payment method of medical expenses,degree of family members’ participation in decision-making and knowledge of treatment decision-making were the influencing factors of renal transplantation recipients’ satisfaction with surgical treatment decision-making（P<0.05,respectively）. Multiple linear regression analysis showed that the degree of knowledge of treatment decision-making was an independent factor influencing the satisfaction of kidney transplantation recipients with participation in treatment decision-making（P<0.001）. Conclusion The satisfaction level of renal transplant patients’ participation in treatment decision-making is moderate and needs to be improved. The patients’ informed degree with treatment decisions is the main factor affecting their satisfaction. Based on the patients’ age and participation of patients’ family members,the medical staff should make a comprehensive evaluation of the patients’ informed degree and also the personalized decision-aid for patients.

Key words: Renal Transplantation Patients, Informed Degree with Treatment Decisions, Satisfaction with Decision-Making Participation, Nursing Care

曹亚雨, 刘惠蓉, 彭玉娇, 杨权, 杨思锐, 陶彦灵, 温贤秀. 肾移植受者手术决策参与满意度的调查研究[J]. 中华护理杂志, 2021, 56(9): 1340-1345.

CAO Yayu, LIU Huirong, PENG Yujiao, YANG Quan, YANG Sirui, TAO Yanling, WEN Xianxiu. Current status and influencing factors of participating satisfaction with surgical treatment decision-making in patients with renal transplantation[J]. Chinese Journal of Nursing, 2021, 56(9): 1340-1345.

图/表 4

表1 肾移植受者一般资料及手术决策参与满意度的单因素分析（n=272）

Table 1 Univariate analysis of total satisfaction score with treatment decision-making participation of renal transplant recipients（n=272）

表2 肾移植受者手术决策参与满意度各条目得分（n=272,分,$\bar{x}$±s）

Table 2 Scores of each item of satisfaction with surgical treatment decision-making and participation of renal transplant recipients（n=272,score,$\bar{x}$±s）

表3 自变量赋值

Table 3 Independent variable assignment

表4 肾移植受者参与手术决策满意度影响因素的多元线性回归分析结果

Table 4 Multiple linear regression analysis of the factors affecting the total score of participation satisfaction in surgical treatment decision-making of renal transplant recipients

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