基于Q方法的老年头颈癌患者术前预立医疗照护计划决策态度探究.pdfVIP

·6·JournalofNursingScienceMay2024Vol.39No.10

·论著·

基于Q方法的老年头颈癌患者术前预立

医疗照护计划决策态度探究

杨慧贤，徐晋霞,徐晶，段睿睿，田艳芝，丁永霞!

摘要：目的分析老年头颈癌患者对术前预立医疗照护计划决策态度，为老年头颈癌患者术前预立医疗照护计划干预模式的构建

提供参考。方法对13例老年头颈癌患者进行半结构访谈，并在文献回顾基础上生成Q陈述，总结、整理后编号并随机排列以备

用；另选取18例老年头颈癌患者按Q方法对Q陈述进行排序，对所得数据进行因子分析，以明确患者的决策态度。结果共提取

3个因子，老年头颈癌患者对术前预立医疗照护计划的决策态度类型可分为3种，即共同决策型、专业决策型、自主决策型，3种类

型患者均认为应在术前进行预立医疗照护计划讨论，均不认为手术前讨论此话题是不吉利或不孝的，3种类型间也存在一定差

异。结论术前与老年头颈癌患者进行预立医疗照护计划讨论具有一定可行性，其参与术前预立医疗照护计划决策的态度各有不

同，医务人员应甄别患者的不同决策类型，针对性制定术前预立医疗照护计划。

关键词：头颈癌；老年患者；手术；预立医疗照护计划；安宁疗护；决策态度；Q方法；质性研究

中图分类号：R473.73；R48D0I:10.3870/j.issn.1001-4152.2024.10.006

AStudyofpreoperativeadvancecareplanningdecision-makingattitudesofelderly

patientsreceivingheadandneckcancersurgerybasedonQmethodology

yYangHui-

xian,XuJinxia,XuJing,DuanRuirui,TianYanzhi,DingYongxia.SchoolofNursing,ShanxiMedicalUniversity,

Taiyuan030001,China

Abstract:ObjectiveToanalyzetheattitudesofolderpatientsreceivingheadandneckcancersurgeryondecisionmakingtowards

preoperativeadvancecareplanning(ACP),informingthedevelopmentofpreoperativeACPinterventionsforolderpatientswith

headandneckcancer.MethodsSemi-structuredinterviewswereconductedwith13elderlypatientsundergoingheadandneckcan-

cersurgery,andQstatementsweregeneratedbasedontheliteraturereview,summarized,organized,numberedandrandomly

rankedforbackup;another18elderlypatientsundergoingheadandneckcancersurgerywereselectedtoranktheQstatementsac-

cordingtotheQmethodology,andtheresultingdataweresubjectedtoafactoranalysisinordertoclarifythepatientsattitudeto-

wardsdecision-making.ResultsAtotalof3factorswereextracted.Thetypesofdecision-makingattitudesofelde