| Patient decision aids（PDAs）are part of the shared decision-making（SDM）process and are effective ways to implement the SDM model,allowing patients and healthcare workers more easily to discuss treatment options.In China,there are millions of patients with atrial fibrillation（AF）who have a high level of conflicts in treatment decisions as well as lacked PDAs.Therefore,this study intended to construct a PDAs for patients with AF,and in the course of medical treatment,the nurse assists the patient in using it.Hoping to to improve the decision-making quality of patients.This study was formed from the following two parts:In the first part,PDAs for AF patients were developed based on the Ottawa Decision Support Framework and Evidence-based Nursing using systematic review,Delphi method and user acceptability survey method.and it consists of evaluating patients’ decision needs,providing decision support information,clarifying patients’ choice preferences,and confirming patients’ decision making.In the second part,a clinical controlled trial was conducted to investigate the hospitalized patients with AF in the department of cardiovascular medicine of a Three-A general hospital from January to March 2021 and January to February 2022.60 patients were equally divided into two groups using convenience sampling method.One group was the control group which patients were offered routine nursing care,and the other group was the intervention group which patients were extra given intervention using PDAs.In order to evaluate intervention effectiveness,general information,control preferences scale（CPS）,decisional conflict scale（DCS）,the satisfaction with decision scale（SDS）and hospital anxiety and depression scale（HADS）for each patient were collected using questionnaire method.The result of the application showed that:1.Before the intervention,more than 60% of patients were passive in decisionmaking.After being intervened,the passive type of actual participation in decisionmaking of patients in the intervention group was reduced to 30%.2.Before intervention,the total score of decision conflict scale in the control group and the intervention group was（25.87±13.78,29.80±12.17）.After intervention,the total scores of the two groups were（12.43±10.42,8.40±5.65）.The scores of information dimension and support dimension of decision conflict scale in the intervention group（1.97±1.47,1.07±1.08）were significantly lower than those in the control group（3.20±2.88,2.17±2.48）,with statistical significance（P < 0.05）.3.Before intervention,the total scores of the anxiety and depression scale in the control group and the intervention group were（9.30±6.97,11.20±9.65）,and after intervention,the total scores of the two groups were（7.27±7.47,6.07±6.95）.The score of anxiety dimension in the intervention group（3.07±3.79）was significantly lower than that before intervention（6.10±5.11）,and the difference was statistically significant（P < 0.05）.PDAs constructed for AF patients in this study,will be helpful for promoting SDM and alleviating patients’ decision-making conflict and anxiety.However,the long-term effects on reducing depression and improving decision satisfaction still need to be further researched.The results of this study also provide references for developing PDAs in China. |
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