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恶性肿瘤患者参与医疗及护理决策满意度现状的调查研究

The patients satisfaction with participation in medical and nursing decision making among cancer patients: a cross-sectional study

摘要:

目的 探讨恶性肿瘤患者参与医疗及护理决策满意度的现状及影响因素,为今后提高医疗、护理服务质量提供参考依据.方法 采用患者基本资料问卷、患者参与临床决策期望量表、患者参与临床决策能力量表和患者参与医疗决策和护理决策满意度调查问卷,对北京肿瘤医院的159例肿瘤患者进行问卷调查.结果 患者参与医疗决策满意度总得分为(45.92±3.91)分,参与护理决策满意度总得分为(34.25±3.31)分.男性患者参与医疗决策、护理决策的满意度评分分别为(46.45±3.24)、(34.68±2.93)分,均高于女性患者的(44.87±4.84)、(33.42±3.84)分,差异有统计学意义(t=2.416,P=0.017;t=2.275,P=0.024);肺癌患者参与医疗决策的满意度评分为(46.51±2.69)分,高于黑色素瘤患者的(43.33±7.07)分,差异有统计学意义(P=0.002);疾病分期为Ⅳ期的肿瘤患者参与护理决策满意度总得分为(34.97±2.24)分,高于Ⅲ期患者的(32.40±4.56)分,差异有统计学意义(P<0.01).同时,患者参与医疗及护理决策的满意度与其参与决策的期望和能力之间均呈正相关.结论 患者参与临床决策的满意度受到性别、疾病分期、疾病诊断以及参与决策的期望和能力等因素的影响.医务人员仍需进一步增加患者对临床决策参与的认知和积极性,进而提高患者参与决策的满意度.

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Objective To explore the patients satisfaction with participation in medical and nursing decision making and the influencing factors among cancer patients, and to provide a basis for developing better medical care services. Methods Totally 159 cancer patients were recruited from Beijing Cancer Hospital, and then were investigated with the general information questionnaire, the patients′ expectation for participation in clinical decision making scale, the patients′ competence for participation in clinical decision making scale, and the patients′satisfaction with participation in medical and nursing decision making questionnaires. Results The total score of patients′satisfaction with participation in medical and nursing decision making were (45.92±3.91) and (34.25±3.31) respectively. Compared with female patients, male patients had higher satisfaction with medical decision making (46.45±3.24&44.87±4.84) and nursing decision making (34.68 ± 2.93&33.42 ± 3.84) (t=2.416, P=0.017;t=2.275, P=0.024);and compared with melanoma patients, lung cancer patients had higher satisfaction with medical decision making (46.51 ± 2.69&43.33 ± 7.07, P=0.002);compared withⅢstage patients, Ⅳstage patients had higher satisfaction with nursing decision making(34.97±2.24&32.40±4.56, P<0.01). Meanwhile, the satisfaction with participation in decision making was significantly positively associated with patients′ expectation and competence for participation in clinical decision making. Conclusions Patients′satisfaction for decision making may vary from different gender, tumor types, disease stages, and patients′expectation and competence. Health care providers still further strength patients′ knowledge and initiative of decision making, and then improve patients′satisfaction with participation in decision making.

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作者: 张宏伟 [1] 侯晓婷 [1] 柏冬丽 [1] 刘晓红 [1] 任芳芳 [1] 李红 [1] 朱广霞 [1] 白玲玲 [1]
栏目名称: 肿瘤科护理
DOI: 10.3760/cma.j.issn.1672-7088.2017.23.013
发布时间: 2017-09-29
基金项目:
北京大学肿瘤医院科学研究基金(2014自主-45) Scientific Research Foundation of Beijing Cancer Hospital
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