Liu Yan-Qiu, Guo Yu-Lin, Xu Jia, Geng Wen-Jing, Li Zhen-Zhen, Jia Ming, Liu Yu-Dan, Zhao Hua
College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi, People's Republic of China.
Department of Rehabilitation, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
Patient Prefer Adherence. 2023 Jan 25;17:249-257. doi: 10.2147/PPA.S394095. eCollection 2023.
To probe into the needs and barriers underlying patients' participation in shared decision-making related to rehabilitation nursing for hemophilic arthropathy.
The phenomenological research approach was adopted to conduct a series of semi-structured, in-depth interviews with 15 patients with hemophilic arthropathy undergoing rehabilitative treatments, 10 caregivers, and 7 healthcare providers from a hemophilia treatment center in Shanxi province, China. Colaizzi's seven-step method of data analysis was applied to organize, analyze, and extract the themes from the interview materials.
Three main themes emerged from the analysis: the status quo of the healthcare system (insufficient decision support systems and mismatch between healthcare providers' and patients' resources), circumstances of provider-patient interactions (lack of information exchange and unbalanced power structure between healthcare providers and patients), and patient-related factors influencing participation in decision-making (lack of self-efficacy, personal characteristics, family and social decision support, and attitude toward participation in decision-making).
Participation in rehabilitation decision-making among patients with hemophilic arthropathy is affected by multiple barriers. Healthcare professionals should improve their understanding of shared decision-making, offer patients active guidance on participating in the decision-making process, prioritize their affective needs, and formulate professional and effective solutions to support shared decision-making as early as possible.
探讨血友病性关节病患者参与康复护理共同决策的需求及障碍。
采用现象学研究方法，对中国山西省一家血友病治疗中心的15例接受康复治疗的血友病性关节病患者、10名照护者和7名医护人员进行了一系列半结构化的深入访谈。应用Colaizzi七步分析法对访谈资料进行整理、分析并提炼主题。
分析得出三个主要主题：医疗体系现状（决策支持系统不足以及医护人员与患者资源不匹配）、医患互动情况（缺乏信息交流以及医护人员与患者之间权力结构失衡）以及影响参与决策的患者相关因素（缺乏自我效能感、个人特征、家庭和社会决策支持以及对参与决策的态度）。
血友病性关节病患者参与康复决策受到多种障碍的影响。医护人员应提高对共同决策的认识，为患者参与决策过程提供积极指导，优先考虑其情感需求，并尽早制定专业有效的解决方案以支持共同决策。
