Study On The Influence Of Shared Decision Making On Function Exercise Adherence On Stroke Patients

Objective: To understand the status of exercise adherence,shared decision making,participating in decision-making about treatment and nursing care and self-efficacy on stroke patients and the differences in social demography;To clarify the correlation between exercise adherence,shared decision making,participating in decision-making about treatment and nursing care and self-efficacy;To investigate the main factors influencing functional exercise adherence of inpatients with stroke.It provides theoretical basis for further developing nursing measures related to shared decision making on clinical work and improving patients’ adherence.Methods: In this study,288 inpatients with stroke who met the inclusion criteria in four grade III first-class hospitals in Jilin Province were conveniently selected from March 2020 to October 2020 through cross-sectional survey.The general situation questionnaire,the 9-item Shared Decision Making Questionnaire(SDM-Q-9),the patient participation in treatment and care decision questionnaire,self-efficacy scale for chronic(SSC)and questionnaire of exercise adherence(EAQ)were used to measure the patients’ shared decision making,treatment and care decision participation,self-efficacy and exercise adherence.SPSS26.0 statistical software was used to analyze and process the data.Results:(1)Shared decision making score for patients with cerebral apoplexy(25.95±10.42),different ethnic groups,professional and cultural level,place of residence,family per income,medical payment,understanding of the disease,whether it is the first time have significant differences on the pathogenesis,statistically significant(P<0.05).(2)Participating in decision-making about treatment and nursing care total score for patients with cerebral apoplexy(82.80±14.86),different careers,cultural degree,marital status,place of residence,living conditions,the main caregivers,family per income,whether the understanding of the disease,with significant risk for the first time,the difference of the statistically significant(P<0.05).(3)Exercise adherence scores for patients with cerebral apoplexy(36.15±7.03),different careers,cultural degree,marital status,place of residence,living conditions,the main caregivers,family per income,medical payment,understanding of the disease,sick time have significant difference,statistically significant(P<0.05).(4)Self-efficacy scores for patients with cerebral apoplexy(36.64±(16)(16)(13)(15)(22)),different nationality,occupation,cultural degree,marital status,place of residence,living conditions,family per income,on the understanding of disease and illness have significant difference,statistically significant(P<0.05).(5)There was a negative correlation between the shared decision making score of stroke patients and the participation in decision-making about treatment and nursing care(r =-0.320,P<0.05),shared decision making score was positively correlated with self-efficacy score(r =0.584,P<0.01),there was a negative correlation between the participation in decisionmaking about treatment and nursing care score and self-efficacy score(r =-0.366,P<0.01),shared decision making score was positively correlated with exercise adherence score(r =0.739,P<0.01),participating in decision-making about treatment and nursing care score was negatively correlated with the exercise adherence score(r =-0.583,P<0.01),the score of self-efficacy was positively correlated with the score of exercise adherence(r =0.601,P<0.01).(6)Shared decision making,participating in decision-making about treatment and nursing care,self-efficacy,occupation,education level,primary caregiver,and medical payment method entered into the regression equation affecting patients’ exercise adherence,jointly explaining the variation amount of 74.4% in the functional exercise adherence of stroke patients(F=70.657,P<0.001).Conclusion:(1)The shared decision making of stroke patients is at a medium level,participating in decision-making about treatment and nursing care of stroke patients is at a medium low level,the exercise adherence of stroke patients is at a medium high level,and the self-efficacy of stroke patients is at a medium high level.(2)There were correlations between stroke patients’ shared decision making,participating in decision-making about treatment and nursing care,self-efficacy and exercise adherence.The better the shared decision making,the higher the participating in decision-making about treatment and nursing care,the higher the self-efficacy,and the better the functional exercise compliance.(3)Shared decision making,participating in decision-making about treatment and nursing care,self-efficacy,occupation,education level,primary caregiver and medical payment method are important factors influencing the functional exercise adherence of stroke patients,among which shared decision perception is the most predictive.