目的 探索心脏移植患者的手术决策困境,为临床实践者实施决策辅助支持提供参考。方法 2023年7-9月,采用目的抽样法选取18例心脏移植患者进行访谈,采用解释现象学方法分析资料、提炼主题。结果 共提炼出4个主题：主体体验困境（身体状况不佳、情感混乱多元化、观念认知水平滞后）、信息支持困境（疾病知识缺乏、信息收集及筛选能力不足、医患沟通障碍）、伦理道德困境（家庭意见冲突、舆论压力大）、现实条件困境（经济条件有限、供体等待期漫长）。结论 心脏移植患者在手术决策上遭遇多重困境,包括身体和情感的双重挑战、信息获取与处理的障碍、伦理道德的困惑以及现实条件的限制。
Abstract
Objective To explore the dilemmas of surgical decision among heart transplant patients and provide reference for clinical practitioners to implement decision assistance support. Methods From July to September in 2023, 18 heart transplant patients were selected by purpose sampling for interviews. Interpretive phenomenological analysis was used to analyze the data and extract themes. Results Four themes were extracted: subject experience dilemma (poor physical condition, affective disorder and pluralism, and poor cognition and conception), information support dilemma (lack of disease knowledge, poor information collection and screening ability, and doctor-patient communication barriers), ethical and moral dilemma (conflict of family opinions, and great pressure from public opinion), practical condition dilemma (poor economic conditions, and long waiting period for donors). Conclusion Surgical decision-making for heart transplant patients is accompanied by multiple dilemmas, including physical and emotional challenges, information acquisition and processing barriers, ethical confusion, and practical constraints.
关键词
心脏移植 /
决策困境 /
医患沟通 /
决策辅助 /
质性研究
Key words
heart transplantation /
decision dilemma /
doctor-patient communication /
decision aid /
qualitative research
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基金
2023年广东省医学科研基金项目（A2023007）
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