以质量求发展,以服务铸品牌

护理学报 ›› 2019, Vol. 26 ›› Issue (22): 38-42.doi: 10.16460/j.issn1008-9969.2019.22.038

• 调查研究 • 上一篇    下一篇

185例重型颅脑外伤患者法定代理人早期决策自我效能现状及影响因素分析

花丽芳1a, 查春花2, 葛燕倩1b   

  1. 江南大学附属医院(无锡三院) 1a.重症医学科; 1b. 急诊科,江苏 无锡 214000;
    2.江阴市第四人民医院 妇产科,江苏 江阴 214421
  • 收稿日期:2019-06-21 发布日期:2020-07-27
  • 作者简介:花丽芳(1990-),女,江苏无锡人,本科学历,主管护师。

Early Decision-making Self-efficacy of 185 Legal Representative of Patients with Severe Craniocerebral Trauma and Its Influence Factors

HUA Li-fang1a, ZHA Chun-hua2, GE Yan-qian1b   

  1. 1a. Dept. of Critical Care Medicine; 1b. Emergency Department, Affiliated Hospital of Jiangnan University Wuxi Third People's Hospital, Wuxi 214000, China;
    2. Dept. of Genaecology and Obstretics, the 4th People's Hospital of Jiangyin, Jiangyin 214421, China
  • Received:2019-06-21 Published:2020-07-27

摘要: 目的 探讨重型颅脑外伤患者法定代理人早期决策自我效能水平,分析其影响因素。方法 采用便利抽样法,于2018年1—12月在无锡和江阴市的3所三级甲等医院选取重型颅脑外伤患者法定代理人185例作为研究对象,采用一般资料问卷、家庭成员决策自我效能量表、疾病不确定感家属量表、社会支持评定量表对其进行调查。采用多元线性回归分析重型颅脑外伤患者法定代理人早期决策自我效能的影响因素。结果 重型颅脑外伤患者法定代理人的早期决策自我效能得分为(42.36±5.39)分;多元线性回归分析结果显示:法定代理人性别、家庭经济状况、疾病不确定感和社会支持情况进入回归方程(P<0.05),共解释重型颅脑外伤患者法定代理人早期决策自我效能总变异的64.7%。结论 重型颅脑外伤患者法定代理人早期决策自我效能处于中等水平,法定代理人的性别、家庭经济状况、疾病不确定感和社会支持情况是法定代理人早期决策自我效能的主要影响因素。医护人员可结合法定代理人的性别、家庭经济状况、疾病不确定和社会支持情况等因素开展决策支持干预,以提高法定代理人早期决策自我效能水平,促进患者利益最大化。

关键词: 颅脑外伤, 替代决策, 自我效能, 社会支持, 疾病不确定感

Abstract: Objective To explore early decision-making self-efficacy of legal representatives of patients with severe craniocerebral trauma and analyze its influence factors. Methods With convenient sampling method, 185 legal surrogates of patients with severe craniocerebral trauma were selected from three tertiary grade A hospitals in Wuxi and Jiangyin from January to December 2018. General data questionnaire, Family Decision Making Self-efficacy Scale, Mishel Uncertainty in Illness Scale-family Member Form and Social Support Scale were used to investigate the subjects. Multivariate linear regression was used to analyze the influencing factors of early decision-making self-efficacy of legal surrogates in patients with severe craniocerebral trauma. Results The score of early decision-making self-efficacy was 42.36±5.39. Multivariate linear regression analysis showed that gender, family income, disease uncertainty and social support of legal surrogates entered into the regression equation (P<0.05), which explained 64.7% of the total variations. Conclusion Early decision-making self-efficacy of legal representatives in patients with severe craniocerebral trauma is in a mediate level and its main influence factors are gender, family income, disease uncertainty and social support. Healthcare staff can carry out decision support interventions in combination with the influence factors, so as to improve the level of self-efficacy of legal surrogate in early decision-making and maximize the interests of patients.

Key words: craniocerebral trauma, alternative decision-making, self-efficacy, social support, disease uncertainty

中图分类号: 

  • R473.6
[1] 王忠诚. 神经外科学[M]. 武汉: 湖北科学技术出版社, 2005:42-54.
[2] 李霞. 论我国成年人民事行为能力欠缺法律制度重构[J]. 政治与法律,2008,11(9):70-76.DOI:10.3969/j.issn.1005-9512.2008.09.011.
[3] 孙遥. 预先医疗指示制度研究[D]. 济南:山东大学, 2017.
[4] 周雯,毛靖,闻曲,等. 肿瘤患者预前指示现况及影响因素调查[J].护理学杂志, 2016,31(24):26-30. DOI:10.3870/j.issn.1001-4152.2016.24.026.
[5] 陈化,徐喜荣. 论临床代理决策中的“患者最佳利益原则”[J].医学与哲学, 2013,34(6B):5-8.
[6] 刘倩丽,关健. 基于数据的临床决策对无行为能力患者治疗选择的潜在意义[J].中国医学伦理学,2016,29(6):978-980. DOI:10.12026/j.issn.1001-8565.2016.06.18.
[7] Dionne-Odom J N, Ejem D, Azuero A, et al. Factors Associated with Family Caregivers' Confidence in Future Surrogate Decision Making for Persons with Cancer[J]. J Palliat Med, 2018, 21(12):1-5.DOI:10.1089/jpm.2018.0148.
[8] 吴琼,尹永田,陈莉军,等. 患者替代决策评估工具及影响因素研究现状[J].中国护理管理, 2018,18(6):858-861. DOI:10.3969/j.issn.1672-1756.2018.06.030.
[9] Nolan M T, Hughes M T, Kub J, et al.Development and Validation of the Family Decision-making Self-efficacy Scale[J]. Palliat Support Care, 2009, 7(3):315-321. DOI: 10.1017/S1478951509990241.
[10] Mishel M H.Adjusting the Fit: Development of Uncertainty Scales for Specific Clinical Populations[J]. West J Nurs Res,1983,5(4):355-370.DOI:10.1177/019394598300500408.
[11] 王文颖,王申,夏大胜,等. 中文版疾病不确定感家属量表的信效度研究[J].护理研究, 2012,26(3A):662-663. DOI:10.3969/j.issn.1009-6493.2012.07.042.
[12] 汪向东. 心理卫生评定量表手册(增订版)[M]. 北京:中国心理卫生杂志社,1999:127-131.
[13] Wendler D, Rid A.Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others[J]. Ann Intern Med,2011,154(5):336-346. DOI:10.7326/0003-4819-154-5-201103010-00008.
[14] 仲华,杨海玲,王红梅. 重型颅脑外伤患者家庭应激支持状况调查[J]. 护理研究, 2004,18(11):1913-1914. DOI:10.3969/j.issn.1009-6493.2004.21.014.
[15] 吴瑛,章左艳.重症颅脑外伤患者照顾者早期心理状况的质性研究[J].上海护理, 2012,12(3):52-55. DOI:10.3969/j.issn.1009-8399.2012.03.018.
[16] 吴瑛,陈亚文,章左艳. 重症颅脑伤患者家属的应对方式及其影响因素[J]. 解放军护理杂志, 2010,27(12):885-887. DOI:10.3969/j.issn.1008-9993.2010.12.002.
[17] Majesko A, Hong S Y, Weissfeld L,et al.Identifying Family Members Who May Struggle in the Role of Surrogate Decision Maker[J]. Crit Care Med, 2012,40(8):2281-2286. DOI:10.1097/CCM.0b013e3182533317.
[18] 杜慧,覃惠英,孙仲文,等. ICU恶性肿瘤患者家属疾病不确定感现状及影响因素分析[J]. 护理学报, 2016,23(21):34-37. DOI:10.16460/j.issn1008-9969.2016.21.034.
[19] Mishel M H.Uncertainty in Illness[J]. Image J Nurs Sch, 1988,20(4):225-232.
[20] Zhang Y.Uncertainty in Illness: Theory Review, Application, and Extension[J]. Oncol Nurs Forum, 2017,44(6):645-649. DOI:10.1188/17.ONF.645-649.
[21] 李亚群,周小梅. 颅脑外伤患者家属早期信息需求分析及其影响因素研究[J]. 当代护士, 2018,25(5B):101-103.
[1] 王利敏, 方继红, 武凤芹, 朱晶, 陈婉宣. 运动恐惧在学龄期四肢骨折患儿自我效能与早期功能锻炼依从性间的中介效应[J]. 护理学报, 2025, 32(3): 1-5.
[2] 林丽华, 盖薇, 王语璇, 尹丽丽, 吕郑晗, 陶艳玲. 自我同情在脑卒中患者社会支持与病耻感的中介作用[J]. 护理学报, 2024, 31(9): 15-19.
[3] 赵洁, 宋雅玲, 畅盼, 郭倩, 王锦华. 慢性心力衰竭患者及其照顾者心理弹性在疾病不确定感与生活质量间的主客体互倚中介模型研究[J]. 护理学报, 2024, 31(7): 17-21.
[4] 林育鹏, 张丽. 231例炎症性肠病复发患者挫败感现状及影响因素分析[J]. 护理学报, 2024, 31(6): 18-21.
[5] 胡晓涵, 占婷婷, 何望生, 乔疏桐, 李雪. 肝豆状核变性患者自我管理体验的质性研究[J]. 护理学报, 2024, 31(5): 17-21.
[6] 曾辉, 史艳茹, 李琦, 董艳, 徐远平, 梁苗苗. 666名军队医院护士医学叙事能力现状及影响因素分析[J]. 护理学报, 2024, 31(5): 73-78.
[7] 张许婷, 罗彩凤, 魏兰芝, 邵校, 尚彬, 卞泽坤, 吕妃, 孙炜怡. 实习护生体面劳动感的潜在剖面分析及影响因素研究[J]. 护理学报, 2024, 31(3): 12-16.
[8] 何洪, 王佳琳, 袁中清, 滕梅, 任黔黔, 蔚萌. 领悟社会支持在护士应急能力与心理负荷的中介效应分析[J]. 护理学报, 2024, 31(3): 63-67.
[9] 吴萍, 于宛辰, 柳嘉怡, 王汕珊, 胡燕. 糖尿病前期人群社会支持研究的范围综述[J]. 护理学报, 2024, 31(21): 49-54.
[10] 李章彰, 罗艳艳, 李根强. 韧性在服务型领导力与临床护士工作投入间的中介效应分析[J]. 护理学报, 2024, 31(15): 1-6.
[11] 张娜, 江玉, 杨丽娜, 于清舒, 王音. 713名临床护士团队效能感现状及影响因素[J]. 护理学报, 2024, 31(14): 69-73.
[12] . 316名儿科护士道德复原力现状及影响因素分析[J]. 护理学报, 2024, 31(12): 59-64.
[13] 黄文嫣, 宋玲花, 廖少娜, 龚雪, 杨晨, 宋慧娟. 情绪调节自我效能感在ICU护士叙事能力与反刍性沉思的中介效应分析[J]. 护理学报, 2024, 31(1): 17-21.
[14] 何叶, 王元姣, 谢珺, 苗姣娜. 心理资本在恢复期脑卒中患者领悟社会支持与患者积极度的中介效应分析[J]. 护理学报, 2023, 30(7): 65-70.
[15] 孙姝怡, 孙国珍, 高敏, 于甜栖, 刘沈馨雨, 汤志杰, 卢静. 自我效能在慢性心力衰竭患者自我调节疲劳与运动依从性的中介效应[J]. 护理学报, 2023, 30(22): 63-67.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!