Objective To study the application value of the doctor-nurse-patient shared decision-making assistance program in the prevention of stroke in patients with atrial fibrillation. Methods Through literature review and expert discussion,treatment decision aid tools were constructed. The convenience sampling was adopted,and 62 atrial fibrillation patients who were willing to participate in treatment decision-making in a tertiary hospital in Zhejiang Province from April to July 2021 were selected as the research subjects. The patients were divided into a test group and a control group,with 31 patients in each group. The test group adopts the doctor-nurse-patient joint shared decision-making assistance program,and the control group adopts the conventional plan. The actual participation in treatment decision-making of the 2 groups of patients,the satisfaction of patients with participating in treatment decision-making,the conflicts of patients’ decision-making,and the INR compliance rate of the 2 groups of patients were analyzed. Results There were statistically significant differences in the degree of patients’ actual participation in treatment decision-making between 2 groups（P<0.001）.The test group was（42.26±6.38） points,and the control group was（26.48±7.31） points. There were statistically significant differences in patients’ satisfaction with participating in treatment decision-making between groups（P=0.04）. The test group was（74.68±11.68） points,and the control group was（49.68±15.26） points. There were statistical differences in the decision-making conflicts of patients between groups（P<0.001）. The test group was（24.81±6.72） points,and the control group was（45.39±8.47） points. There were statistically significant differences in the INR compliance rate of patients between 2 groups（P<0.001）. The INR compliance rate of the test group was 54.17%,and the INR compliance rate of the control group was 14.29%. Conclusion The treatment decision-making assistance for patients with atrial fibrillation in the prevention of stroke have significant clinical significance on patients’ participation in treatment decision-making,treatment decision-making satisfaction,decision-making conflict and INR compliance rate.

Objective To explore the fatigue development trajectory and influencing factors of postoperative patients with acute myocardial infarction（AMI）. Methods From December 2019 to January 2021,206 patients with first AMI in the cardiology department of a tertiary hospital in Huzhou were selected by convenience sampling method. The multidimensional fatigue scale-20 was used to investigate the patient’s fatigue level on the second day after admission and 1,2,4 months after discharge,and the latent class growth model and single factor analysis were used for data processing. Results It is recognized that the fatigue trajectory of AMI patients is divided into 3 potential categories,namely,the obvious improvement group（15.2%）,the slow remission group（62.8%）,and the continuous fatigue group（22.0%）;single factor analysis shows that the 3 trajectory categories are different with statistical significance in gender （χ²=29.384,P<0.001）,marital status （χ²=6.774,P=0.034）,number of comorbidi-ties（χ²=27.131,P<0.001） and cardiac function classification（χ²=20.416,P<0.001）. Conclusion The fatigue of most patients with AMI can be improved within 4 months from acute admission to discharge. There is group heterogeneity in fatigue trajectory. Medical staff should formulate staged and specific full-course nursing interventions according to different trajectory categories.