急性缺血性脑卒中静脉溶栓患者家属替代决策辅助工具的构建及应用

doi:10.3761/j.issn.2096-7446.2026.10.003

摘要/Abstract

摘要：

目的构建急性缺血性脑卒中（acute ischemic stroke，AIS）静脉溶栓家属替代决策辅助工具，并探讨其初步应用效果。方法基于前期质性研究、证据整合、专家函询、用户调试形成决策辅助工具终版。采用类实验研究方法，选取2024年2月—11月在苏州市某三级甲等医院急诊科的AIS患者及其家属替代决策者62例。对照组采取常规医疗及护理模式，试验组在常规医疗及护理模式的基础上实施决策辅助工具干预措施。比较两组家属替代决策者干预后的决策困境、决策满意度、决策耗时。结果试验组家属替代决策者的决策困境得分、决策耗时低于对照组，决策满意度显著高于对照组，差异具有统计学意义（均P<0.05）。结论 AIS静脉溶栓患者家属替代决策辅助工具能够降低家属替代决策者的决策困境、决策耗时，提高决策满意度。

关键词: 急性缺血性脑卒中, 静脉溶栓, 决策辅助工具, 替代决策者, 应用研究

Abstract:

Objective To develop a decision aid for family surrogate decision makers with intravenous thrombolysis in acute ischemic stroke（AIS） patients，and explore its preliminary clinical application effects. Methods The final version of the decision aid was developed through preliminary qualitative research，evidence synthesis，expert consultation，and user testing. A quasi-experimental study design was employed. From February to November 2024，62 AIS patients and their family surrogate decision-makers were recruited from the emergency department of a tertiary-level hospital in Suzhou. The control group received standard medical and nursing care，while the intervention group received decision aid in addition to standard care. The study compared post-intervention scores on the decision dilemma and decision satisfaction scales，as well as decision-making duration between the two groups of family surrogate decision-makers. Results The experimental group demonstrated significantly reduced decision dilemma，decision-making time among family surrogate decision-makers and increased decision satisfaction（P<0.05）. Conclusion The AIS intravenous thrombolysis family surrogate decision aid effectively reduces decision dilemmas and time among family surrogate decision-makers while enhancing decision satisfaction.

Key words: Acute Ischemic Stroke, Intravenous Thrombolysis, Decision Aids, Surrogate Decision Makers, Applied Research

薛海燕, 朱亚芳, 张梦, 谭丽萍, 陆娟. 急性缺血性脑卒中静脉溶栓患者家属替代决策辅助工具的构建及应用[J]. 中华急危重症护理杂志, 2026, 7(10): 1171-1178.

XUE Haiyan, ZHU Yafang, ZHANG Meng, TAN Liping, LU Juan. The application of family surrogate decision aid for intravenous thrombolysis in acute ischemic stroke patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(10): 1171-1178.

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