摘要
目的分析围透析期慢性肾脏病(CKD)患者透析治疗决策冲突行为,为制订决策支持策略提供依据。方法采用目的抽样法,于2024年7-9月对在上海市某三级甲等医院接受治疗的围透析期CKD患者15例进行半结构化访谈。采用内容分析法对资料进行整理和分析。结果围透析期CKD患者透析决策困境可归纳为3个主题和9个亚主题,分别是医护人员支持不足(医患沟通少/不充分、专业健康教育渠道匮乏、个性化教育内容与措施不突出、共同决策权行使力度弱),家庭支持不足(家庭负担限制、同理心支持低),自身问题(自身知识掌握不全面、自身理解能力偏差、健康信念缺乏)。结论围透析期CKD患者透析决策受多重因素的干扰,导致患者决策困境,护士应该制订适宜的决策支持策略,以尽可能降低患者的决策冲突,提升决策质量,降低患者的决策后悔,提高其满意度。
Objective To analyze the decision conflicts regarding dialysis in peridialysis chronic kidney disease(CKD)patients,aiming to provide evidence for developing decision support strategies.Methods A total of 15 peridialysis CKD patients treated at a GradeⅢ⁃A hospital in Shanghai from July to September 2024 were selected by purposive sampling to receive semi⁃structured interviews.Interview data were sorted out and analyzed using the content analysis method.Results The decision-making dilemmas regarding dialysis in peridialysis CKD patients were categorized into 3 topics and 9 sub⁃topics:inadequate support from healthcare providers(insufficient physician⁃patient communication,lack of professional health education channels,absence of individualized educational contents and measures,and limited involvement in shared decisionmaking);inadequate family support(family burden,insufficient empathetic support);personal challenges(insufficient knowledge,insufficient understanding and lack of health beliefs).Conclusion The decisionmaking regarding dialysis in peridialysis CKD patients faces multiple interference factors,leading to decisionmaking dilemmas.Nurses should develop suitable decision support strategies to reduce decision conflicts,enhance decision quality,minimize decision regrets in patients and improve their satisfaction.
作者
张三利
周敏
裴淼
李佳慧
ZHANG Sanli;ZHOU Min;PEI Miao;LI Jiahui(Shanghai Changzheng Hospital,Shanghai 200003)
出处
《上海护理》
2025年第8期15-19,共5页
Shanghai Nursing
关键词
围透析期
慢性肾脏病
透析方式
决策
决策冲突
质性研究
Peridialysis
Chronic kidney disease
Dialysis modality
Decision-making
Decision conflict
Qualitative study
