首页|急性缺血性脑卒中代理决策者溶栓决策焦虑与决策时长的相关性

急性缺血性脑卒中代理决策者溶栓决策焦虑与决策时长的相关性

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目的 探讨急性缺血性脑卒中患者的代理决策者在溶栓决策过程中的焦虑程度、影响因素及其与决策时长的相关性.方法 选取2019年9月-2021年12月在郑州大学第一附属医院急诊科就诊的急性缺血性脑卒中患者及其代理决策者为研究对象.收集患者及代理决策者的社会人口学资料及患者疾病相关资料.对代理决策者进行状态-特质焦虑量表、决策参与期待量表、维克森林医师信任量表、感知社会支持量表评估.使用SPSS 26.0对数据进行处理,使用Pearson相关分析、Spearman相关分析和岭回归分析进行统计分析.结果 代理决策者状态焦虑得分为(49.47±9.04)分,18.2%(70/383)的决策者决策时长超过15 min.代理决策者状态焦虑得分与决策时长呈正相关(r=0.189,P<0.001).代理决策者状态焦虑水平的影响因素包括社会人口学因素(决策者及患者年龄、付费者与患者关系、决策者是否承担本次医疗费用、患者医保类型)、心理因素(对医师的信任水平、感知社会支持)、患者疾病相关因素(患者脑卒中复发次数、患者国立卫生研究院卒中评分量表评分)、决策过程的特征(患者是否参与决策、决策者在决策过程中的角色)(均P<0.05).结论 大部分代理决策者存在焦虑情绪,医护人员在进行溶栓知情同意沟通时应关注决策者的情绪并采用适当的沟通技巧,缓解代理决策者的焦虑,从而缩减决策时间.
The correlation between thrombolysis decision-making anxiety and decision-making duration among surrogate decision-makers of patients with acute ischemic stroke
Objective To explore the anxiety level,influencing factors among surrogate decision-makers of patients with acute ischemic stroke during thrombolysis decision-making,and their correlation with decision-making duration.Methods Acute ischemic stroke patients and their surrogate decision-makers who visited the Emergency Department of the First Affiliated Hospital of Zhengzhou University from September 2019 to December 2021 were selected as the research subjects.Sociodemographic data and disease related data of patients and surrogate decision-makers were collected.Surrogate decision-makers were evaluated with the state-trait anxiety inventory,decision participation expectation scale,Wake Forest physician trust scale,and perceived social support scale.SPSS 26.0 software was used for data processing.Pearson correlation a-nalysis,Spearman correlation analysis and ridge regression analysis were used for statistical analysis.Results The score of state anxiety of decision-makers was(49.47±9.04),and 18.2%(70/383)of decision-makers had a decision duration exceeding 15 minutes.The score of state anxiety of decision-makers was positively correlated with decision duration(r=0.189,P<0.001).The influencing factors of state anxiety level of deci-sion-makers included sociodemographic factors(age of decision-makers and patients,relationship between payers and patients,whether decision-makers bear the current medical expenses,type of medical insurance for patients),psychological factors(trust level in physicians,perceived social support),factors related to patient disease(numbers of stroke relapses,National Institutes of Health stroke scale scores for patients),character-istics of the decision-making process(whether patients participate in the decision-making process,and the role of decision-makers in the decision-making process)(all P<0.05).Conclusion Most surrogate deci-sion-makers experience anxiety.Medical staff should pay attention to the emotions of decision-makers and a-dopt appropriate communication skills when communicating with informed consent for thrombolysis,alleviate the anxiety of surrogate decision-makers,so as so reduce the decision-making duration.

Acute ischemic strokeThrombolysisState anxietyDecision-makingInflu-ence factors

杨彩侠、马珂珂、郭丽娜、董小方、李亚鹏、郭园丽

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郑州大学第一附属医院神经内三科,郑州 450000

急性缺血性脑卒中 溶栓 状态焦虑 决策 影响因素

河南省科技攻关项目(河南省科技攻关计划)

222102310246

2024

中华行为医学与脑科学杂志
中华医学会 济宁医学院

中华行为医学与脑科学杂志

CSTPCD北大核心
影响因子:1.472
ISSN:1674-6554
年,卷(期):2024.33(2)
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