摘要
目的探讨和分析关节置换患者手术决策过程,为促进医患间手术决策的有效沟通和患者的理性决策提出建议。方法2018年1-10月,采用目的性抽样法选择海军军医大学第一附属医院骨关节科收治的13例拟(或已)行骨关节置换术患者进行半结构式深入访谈,了解其手术决策过程。结果骨关节置换患者的手术决策过程可归纳为4个主题,即病痛困扰引发手术决策、信息支持影响手术决策、手术决策者因人而异、手术决策满意度与康复锻炼有关等。结论关节置换手术决策具有挑战性,医护工作者在与患者及家属沟通过程中,须正确引导患者对手术的心理期望,充分尊重患者的知情同意权,同时关注医疗费用支出对患者健康的负面影响。
Objective To explore the patients'decision-making process regarding joint replacement surgery and to provide a reference for doctor-patient communication in informed consent process and patients’rational decision-making.Methods Purpose sampling was used to select patients who were admitted for or had taken joint replacement surgery from January to October 2018.A total of 13patients accepted face-toface semi-structured interviews by using qualitative descriptive method and Colaizzi's data analysis.Results Four themes related to the patients’decision-making process of surgery emerged from the interview:the pain triggered surgery decision-making,information support played a very important role of making decision, the decision-making varied by person,and the patients’satisfaction of the surgery was related with rehabilitation exercise.Conclusions Decision-making of joint replacement surgery is challenging.Health practitioners should help the patients examine their expectations and goals,and respect the patients’autonomy and consider the influence of medical expenditure.
作者
吴菁
朱小霞
叶旭春
王成功
李林
WU Jing;ZHU Xiaoxia;YE Xuchun;WANG Chengong;LI Lin(School of Psychology and CognitiveScience,East China Normal University,Shanghai 200062,China;Department of Orthopedics and Arthrology,First Hospital Affiliated to Naval Medical University,Shanghai 200433,China;School of Nursing,Naval Medical University,Shanghai 200433,China)
出处
《解放军护理杂志》
CSCD
北大核心
2019年第7期15-18,23,共5页
Nursing Journal of Chinese People's Liberation Army
基金
上海市卫生和计划生育委员会科研课题(201640326)
关键词
关节置换术
决策
质性研究
医患沟通
arthroplasty
decision-making
qualitative research
doctor-patient communication
