护理学报 ›› 2023, Vol. 30 ›› Issue (7): 33-37.doi: 10.16460/j.issn1008-9969.2023.07.033
毛赛璐1, 曾莉2
摘要: 目的 综述ICU患者代理决策者决策冲突的研究进展,以期为科学化管理ICU患者代理决策者的决策冲突提供思路和参考。方法 检索国内外相关数据库,对决策冲突的概念、评估工具、代理决策者决策冲突的表现形式及影响因素进行综述。结果 ICU患者代理决策者决策冲突发生率高,表现形式各异,影响因素众多,负面影响较广,但目前临床缺乏有效识别和干预。代理决策者决策冲突的表现形式包括:决策偏好的冲突、决策模式的冲突、决策内容的冲突、决策过程信息缺乏、决策主体情绪困境。代理决策者决策冲突的影响因素包括患者相关因素、代理决策者相关因素、家庭相关因素、医疗相关因素、文化相关因素。结论 科学化管理代理决策者决策冲突对于提高决策质量,改善患者最终结局具有重要意义,但目前医护人员对决策冲突的认知不足且缺乏成熟的评价体系及有效的决策辅助手段,未来有待深入研究以改善现状。
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