Application Of Shared Decision-making Intervention In First-episode Stroke Patients

Objective:(1)To understand the real experience of the first-episode stroke patients’ medical treatment process through qualitative research,to explore the medical needs of stroke patients in depth from the patient’s perspective,and to lay the foundation for quantitative research to clarify patients’ values and decision-making needs,in order to provide clinical medical staff with targeted Sexual interventions provide the basis.(2)The application of shared decision-making intervention in patients with first-episode ischemic stroke aims to stimulate patients’ awareness of autonomous decision-making and participate in clinical nursing decision-making,improve patients’ disease-related knowledge and medication compliance,and reduce the occurrence of negative emotions.And then promote the recovery of the patient’s neurological function to comprehensively improve the patient’s prognosis.Methods:(1)Using the purposeful sampling method,from May to July 2021,17 first-episode stroke patients in the neurology department of a tertiary hospital in Taiyuan City,Shanxi Province were selected as the research objects,and semi-structured interviews were conducted using the phenomenological research method,and Colaizzi 7 Step-by-step analysis was used to analyze the interview data and refine the themes.(2)From March to October 2021,90 first-episode ischemic stroke inpatients in the neurology department of a tertiary hospital in Shanxi Province were selected as the research objects,and the patients were divided into the control group and the experimental group according to the time of admission.The group used the shared decision-making intervention mode,and the National Institute of Health Stroke Scale(NIHSS),Hamilton anxiety rating scale(HAMA),Morisky medication adherence were used at admission and discharge respectively.Scale(MMAS-4),Stroke Patient Knowledge and Attitude Questionnaire(Questionnaire of Stroke Related Knowledge and Attitude,SKAQ)and Patient Decision Participation Satisfaction Scale were used to evaluate patients.Descriptive analysis,t-test and chi-square test were used to analyze the patients.Impact of shared decision-making interventions on patient outcomes.Results:(1)Qualitative research: Through interviews and data analysis,4 themes were finally extracted: lack of disease-related knowledge;confusion and helplessness when admitted to hospital due to sudden physical disability;in the current epidemic situation,the role change caused the patient’s inner weakness and loneliness A sense of abandonment resulting from the impending interruption of nursing rehabilitation upon discharge.(2)Quantitative research: After the intervention,the NIHSS score(5.82±2.86)and HAMA score(5.36±2.45)of the experimental group were lower than those of the control group,and the difference was statistically significant(P<0.05);MMAS-4 score(7.52±0.29)was higher than the control group,the difference was statistically significant(P<0.05);in addition to the basic knowledge(3.51±1.16)in the knowledge scale of stroke patients,other dimensions and total scores(19.89±2.30)in the experimental group were higher than those in the control group,the difference was statistically significant(P<0.05),attitude part,each dimension and total score(41.60±2.18)were higher than the control group,the difference was statistically significant(P<0.05);after the intervention,the patients in the experimental group made decisions participation satisfaction scale score(66.00±4.99)was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:(1)Medical staff should meet patients’ needs for disease-related knowledge through personalized education.In addition,medical staff should pay more attention to the patient’s psychological deficiency when paying attention to the development of the disease,so that they can enjoy a sense of belonging and promote hospital-community continuity of services.The continuous improvement of the system can effectively ensure the continuous rehabilitation training of patients.(2)Shared decision-making intervention can improve the patient’s disease-related knowledge level,have a more positive attitude towards the disease,effectively improve the recovery of the patient’s neurological function,reduce the patient’s psychological anxiety symptoms,and stimulate the patient’s decision-making autonomy in the process of encouraging the patient to participate in decision-making.process of empowerment and improve patient satisfaction with decision-making participation.