应对决策冲突：激光周边虹膜切开术预防原发性闭角型青光眼
Navigating decisional conflict: laser peripheral iridotomy for primary angle-closure glaucoma prevention.
作者信息
Chen Yi-Jie, Dai Jing-Yao, Le Rong-Rong, Zhang Xiao-Xian, Huang Jia-Li, Lu Hu-Jie, Sun Yi-Wen, Liang Yuan-Bo, Chen Yan-Yan, Zhou Wen-Zhe
机构信息
School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
出版信息
Int J Ophthalmol. 2025 Apr 18;18(4):627-636. doi: 10.18240/ijo.2025.04.08. eCollection 2025.
AIM
To investigate decisional conflict among patients diagnosed with primary angle-closure suspect (PACS) or primary angle-closure (PAC) who are considering laser peripheral iridotomy (LPI) treatment.
METHODS
A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023. These participants then completed a general information questionnaire and the Decision Conflict Scale. Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.
RESULTS
The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01, with 99.1% of these individuals reporting experiencing decisional conflict. Multiple linear regression analysis revealed that females (=0.002) and patients with a shorter duration of the disease (=0.006) had higher levels of decisional conflict. Additionally, patients diagnosed during medical visits (=0.049), those who refused LPI treatment (=0.032), and individuals facing significant economic burdens related to medical expenses (=0.005) exhibited higher levels of decisional conflict. Furthermore, patients who preferred to make medical decisions independently (=0.023) and those who favored involving family members in decision-making (=0.005) experienced increased levels of decisional conflict.
CONCLUSION
Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict. Healthcare professionals should thoroughly assess a range of factors that influence this conflict, including gender, duration of disease, method of diagnosis acquisition, LPI treatment, economic burden of medical expenses, and patient preferences regarding medical decision-making. By considering these variables, tailored decision support can be developed to address individual patient needs, ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.
目的
调查被诊断为原发性闭角型青光眼可疑患者（PACS）或原发性闭角型青光眼（PAC）且正在考虑接受激光周边虹膜切开术（LPI）治疗的患者的决策冲突情况。
方法
通过便利抽样，从2023年3月至2023年12月共选取了111名被诊断为PACS或PAC的个体。这些参与者随后完成了一份一般信息问卷和决策冲突量表。采用多元线性回归进行数据分析，以揭示影响决策冲突的因素。
结果
PACS或PAC患者的平均决策冲突评分为48.58±10.01，其中99.1%的个体表示经历了决策冲突。多元线性回归分析显示，女性（=0.002）和病程较短的患者（=0.006）的决策冲突水平较高。此外，在就诊时被诊断的患者（=0.049）、拒绝LPI治疗的患者（=0.032）以及面临重大医疗费用经济负担的个体（=0.005）表现出较高的决策冲突水平。此外，倾向于独立做出医疗决策的患者（=0.023）和倾向于让家庭成员参与决策的患者（=0.005）的决策冲突水平有所增加。
结论
接受LPI治疗的PACS或PAC患者经常会遇到重大的决策冲突。医疗保健专业人员应全面评估一系列影响这种冲突的因素，包括性别、病程、诊断获取方法、LPI治疗、医疗费用的经济负担以及患者对医疗决策的偏好。通过考虑这些变量，可以制定量身定制的决策支持措施来满足个体患者的需求，最终减少决策冲突并优化关于治疗方案的决策质量。
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