医护患共享决策模式对老年类风湿关节炎患者衰弱状态的影响

The effect of the shared decision-making model among doctors,nurses and patients on the frail status of elderly patients with rheumatoid arthritis

中文关键词: 老年  类风湿关节炎  衰弱  医护患共享决策模式  共享决策模式  自我效能感  依从性  生活质量

英文关键词: elderly  rheumatoid arthritis  frailty  shared decision-making model among doctors  nurses and patients  shared decision-making model  self-efficacy  compliance  quality of life

中文摘要:

      目的 探讨医护患共享决策模式对老年类风湿关节炎患者衰弱状态的影响.方法 选取 2022 年 2 月—2023年1 月上海交通大学医学院附属第九人民医院收治的风湿免疫科类风湿关节炎住院患者 90 例,按照随机数字表法分为试验组和对照组,每组45 例.2 组在常规治疗的同时,对照组患者给予常规护理,试验组患者在常规护理基础上实施医护患共享决策模式干预.观察并比较2 组干预前和干预 3 个月Tilburg衰弱量表得分、关节炎自我效能感量表评分、Morisky用药依从性量表评分和类风湿关节炎患者生活质量量表评分变化.结果 干预 3 个月,试验组的Tilburg衰弱量表得分低于对照组(P＜0.05),试验组关节炎自我效能感量表评分、Morisky用药依从性量表评分、类风湿关节炎患者生活质量量表的生理功能、心理功能、健康自我认识各维度得分及总分均高于对照组,差异均有统计学意义(P＜0.05).结论 医护患共享决策模式有助于改善老年类风湿关节炎患者衰弱状态,提高自我效能感及用药依从性,提升患者生活质量.

英文摘要:

      Objective To investigate the effect of shared decision-making(SDM)model among doctors,nurses and patients on the frail status of elderly patients with rheumatoid arthritis(RA).Methods A total of 90 patients with RA admit-ted to Department of Rheumatology and Immunology,Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao-tong University from February 2022 to January 2023 were selected and divided into experimental group and control group ac-cording to the random number table method,with 45 cases in each group.Both groups received routine treatment.At the same time,the control group received routine nursing,while the experimental group received a SDM intervention based on routine nursing.Before and 3 months after intervention,the changes in the scores of the Tilburg Frailty Indicator(TFI),Arthritis Self-efficacy Scale-8(ASES-8),Morisky Medication Adherence Scale-8(MMAS-8),and the quality of life questionnaire for pa-tients with RA were observed and compared between the two groups.Results After 3 months of intervention,the TFI score of the experimental group was lower than that of the control group(P＜0.05),the scores of ASES-8 and MMAS-8 of the experi-mental group were higher than those of the control group(P＜0.05);the dimension scores of physiological function,psycho-logical function,and health self-awareness and total scores of the quality of life questionnaire for patients with RA of the experi-mental group were higher than those of the control group,and the differences were statistically significant(P＜0.05).Conclusion SDM among doctors,nurses and patients is helpful to improve the frail status of elderly patients with rheumatoid arthritis,enhance their self-efficacy and medication compliance,and improve their quality of life.