主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (8): 1276-1280.doi: 10.3969/j.issn.1672-1756.2025.08.028

• 专科管理 • 上一篇    

体外膜肺氧合治疗患者上机前家属决策冲突现状及影响因素分析

肖苏琴 汤凌鹏 刘洪所 熊琴 江榕 洪都   

  1. 南昌大学第一附属医院重症医学科,330000 南昌市(肖苏琴,汤凌鹏,刘洪所,熊琴,江榕);麻醉手术部(洪都)
  • 出版日期:2025-08-15 发布日期:2025-08-15
  • 通讯作者: 江榕,本科,主任护师,科护士长,E-mail:1454952385@qq.com
  • 作者简介:肖苏琴,硕士,主管护师

The status and influencing factors of decisional conflicts among family members of patients undergoing Extracorporeal Membrane Oxygenation therapy before initiation

XIAO Suqin, TANG Lingpeng, LIU Hongsuo, XIONG Qin, JIANG Rong, HONG Du   

  1. Department of Critical Care Medicine, Nanchang University First Affiliated Hospital, Nanchang, 330000, China
  • Online:2025-08-15 Published:2025-08-15
  • Contact: E-mail:1454952385@qq.com

摘要: 目的:调查体外膜肺氧合(Extracorporeal Membrane Oxygenation,ECMO)治疗患者上机前家属决策冲突现状并分析其影响因素,为制定干预措施、减轻家属决策困境、提高其决策质量提供依据。方法:采用便利抽样法,选取2023年1月至2025年4月南昌市某三级甲等医院重症监护室收治的169例拟行ECMO治疗的患者家属作为研究对象,使用一般资料调查表、决策冲突量表、决策疲劳量表、决策准备量表、领悟社会支持量表及维克森林医师信任量表进行调查。采用二元Logistic回归分析决策冲突的影响因素。结果:ECMO治疗患者上机前家属决策冲突发生率为63.3%。二元Logistic回归分析显示,决策疲劳、对患者疾病状况和ECMO治疗相关信息的了解程度、决策准备、对医师的信任度和社会支持感知是其影响因素(均P<0.05)。结论:ECMO治疗患者上机前家属决策冲突处于较高水平。建议护理管理者根据影响因素对决策冲突水平较高的患者家属进行干预,以减轻其决策困境,提高决策质量。

关键词: 体外膜肺氧合;决策冲突;家属;影响因素;危重症护理

Abstract: Objective: To investigate the current status of decisional conflicts among family members of patients before initiating Extracorporeal Membrane Oxygenation (ECMO) therapy and to analyze its influencing factors, in order to provide a basis for intervention development to alleviate their decisional conflicts and improve decision quality. Methods: Using a convenience sampling method, A total of 169 family members of patients scheduled to undergo ECMO treatment in the ICU of a tertiary grade A hospital were recruited from January 2023 to April 2025 in Nanchang. Questionnaires used in this study included the general information questionnaire, the Decisional Conflict Scale, the Preparation for Decision Making Scale, the Decisional Fatigue Scale, the Multidimentional Scale of Perceived Social Support, and the Wake Forest Physician Trust Scale. Binary Logistic regression analysis was employed to identify the influencing factors. Results: The incidence of decisional conflicts among family members of ECMO patients was 63.3%. Binary Logistic regression analysis revealed that decision fatigue, understanding of the patient's disease status and ECMO treatment information, decision preparedness, physician trust, and awareness of social support were the influencing factors of the decisional conflicts (all P<0.05). Conclusion: The level of decisional conflicts among family members of ECMO patients is high. Nursing managers can implement interventions according to the influencing factors targeting at family members experiencing high levels of decisional conflicts to alleviate their decisional difficulties and improve their decision quality.

Key words: Extracorporeal Membrane Oxygenation; decisional conflict; family members; influencing factor; critical care nursing

中图分类号:  R47;R197