慢性病患者预立医疗照护计划准备度及其影响因素的研究

doi:10.3761/j.issn.0254-1769.2020.07.017

摘要/Abstract

摘要：

目的了解慢性病患者预立医疗照护计划（advance care planning,ACP）准备度现状及影响因素,为ACP实施提供参考。方法采用预立医疗照护计划准备度量表、社会支持评定量表、简易应对方式问卷、维克森林医师信任量表中文修订版、世界卫生组织生活质量测定量表简表中文版等调查工具对在北京市2所社区卫生服务中心便利选取的168例慢性病患者进行调查。采用多元线性逐步回归分析ACP准备度的影响因素。结果 168例慢性病患者ACP准备度得分为（87.48±12.96）分,消极应对、积极应对、就医信任度、病程持续时间、照顾临终亲属经历是慢性病患者ACP准备度的主要影响因素（均P<0.05）。结论慢性病患者ACP准备度处于中等偏上水平,医护人员应识别病程较长、有照顾临终亲属经历的慢性病患者,促进就医信任度,指导患者采取积极应对方式,以进一步提高患者ACP准备度。

关键词: 慢性病, 预立医疗照护计划, 准备度, 社区保健护理

Abstract:

Objective To investigate the current status of advance care planning（ACP） readiness for chronic diseases patients and analyze its influencing factors. Methods 168 chronic diseases patients from 2 Community Health Service Centers in Beijing were investigated by ACP readiness scale,Social Support Rating Scale,Simplified Coping Style Questionnaire,Chinese version of Wake Forest Physician Trust Scale,WHOQOL-BREF and etc. The data was analyzed by multivariate stepwise regression analysis. Results The total score of ACP readiness of chronic diseases patients was（86.33±14.15）. The influencing factors included negative coping,positive coping,trust in physicians,duration of illness,experience of taking care of families at dying（P<0.05 for all）. Conclusions ACP readiness in chronic diseases patients is above the medium level. The medical staffs should identify patients with longer duration of diseases and more experience of taking care of families at dying,improve doctor-patient trust and positive coping solutions,so as to further improve ACP readiness.

Key words: Chronic Disease, Advance Care Planning, Readiness, Community Health Nursing

王心茹, 绳宇. 慢性病患者预立医疗照护计划准备度及其影响因素的研究[J]. 中华护理杂志, 2020, 55(7): 1049-1054.

WANG Xinru, SHENG Yu. Investigation on advance care planning readiness of patients with chronic diseases and its influencing factors[J]. Chinese Journal of Nursing, 2020, 55(7): 1049-1054.

图/表 4

表1 慢性病患者ACP准备度得分情况（n=168）

表2 慢性病患者ACP准备度各维度得分最低的条目

表3 不同特征慢性病患者预立医疗照护计划准备度单因素分析(n=168)

表4 慢性病患者预立医疗照护计划准备度多元线性回归分析结果（n=168）

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