组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2024, Vol. 20 ›› Issue (6): 687-.

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基于选项网格理论构建乳房再造患者决策辅助方案的效果评价

  

  • 出版日期:2024-12-02 发布日期:2025-01-03

Evaluation of the effect of constructing a decision aid program for breast reconstruction patients based on option grid theory

  • Online:2024-12-02 Published:2025-01-03

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摘要：

　目的　通过选项网格理论构建乳房再造患者决策辅助方案，并评价其临床应用效果。方法　参考渥太华决策支持框架，通过文献检索、相关领域专家论证，构建患者决策辅助基本方案。根据纳入标准，选取2023年1—12月接受乳腺癌根治术后乳房重建的患者，将1—6月入院患者作为对照组，7—12月入院患者作为试验组。研究开始前，向患者说明研究目的、方法和可能的结果，在获得患者同意后，填写知情同意书、一般情况调查表、决策困境量表。对照组采用常规护理方法，试验组在常规护理的基础上，增加选项网格决策辅助，帮助患者进行决策辅助。术后3个月、1年时，向患者发放决策困境量表和REAST-Q量表的术后模块。结果　试验组术后3个月、术后1年的决策困境3个维度得分和总分明显低于对照组（P＜0.05）。患者BREAST-Q术后模块得分显示，术后3个月及术后1年，在社会心理健康、躯体健康、性健康、乳房满意度、医生满意度、信息满意度、医疗团队满意度方面，试验组得分均明显高于对照组（P＜0.05）。结论　基于选项网格理论构建的乳房再造手术患者决策辅助方案可有效缓解患者决策困境，提高患者健康相关生活质量和患者满意度。

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Abstract:

Objective To construct decision aid program for breast reconstruction patients by option grid theory and evaluate its clinical application. Methods Based on the reference of Ottawa decision support Framework， experts in related fields demonstrated and constructed the basic plan of patient decision assistance through literature search. According to the inclusion criteria， patients who received breast reconstruction surgery after breast cancer surgery from January to December 2023 were selected. Patients admitted from January to June were selected as the control group， and those admitted from July to December were selected as the test group. Before the start of the study， the researcher explained the research purpose， method and possible results to the study subjects. After obtaining the consent of the patients， the researchers filled in the informed consent form， the general situation questionnaire and the decision dilemma scale. The control group adopted the conventional nursing method， and the experimental group added the option grid decision aid on the basis of the conventional nursing to help the patients with decision aid. Three months and one year after surgery， patients were given the decision dilemma scale and the postoperative module of BREAST-Q quantity. Results The total score and three dimension scores of decision dilemma of the experimental group at 3 months and 1 year after surgery were significantly lower than those of the control group （P<0.05）. The postoperative module scores of the patients' BREAST-Q showed that 3 months and 1 year after surgery， the scores of the experimental group were significantly higher than those of the control group in terms of social and psychological health， physical health， sexual health， breast satisfaction， doctor satisfaction， information satisfaction and medical team satisfaction （P<0.05）. Conclusion The decision assistance scheme for patients undergoing breast reconstructive surgery based on option grid theory can effectively alleviate the decision-making dilemma of patients， improve the health-related quality of life and patient satisfaction.

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