Construction And Application Of Co-decision Aids For Crohn's Disease Patients

Research Purpose:1.A knowledge requirement questionnaire and a knowledge base for co-decision-making for patients with Crohn's disease were developed based on the assessment of patients' needs.2.Through the application of co-decision-making assistant scheme,the degree of CD patients' actual participation in treatment decision-making,the degree of participation in decision-making satisfaction,and the degree of decision-making dilemma were improved.Research Methods:1.Through literature reading and interview,patients' needs were obtained,knowledge needs questionnaire was formed,and formal questionnaire was formed by item analysis,screening and reliability and validity test.The reliability was evaluated by Cronbach's Coefficient and retest reliability,and the validity was mainly evaluated by content validity and construct validity.2.The scientificity of the shared decision knowledge base was evaluated by using Delphi's expert inquiry method.3.The application study of supplementary protocol was carried out by using different case-control test,to evaluate the clinical effect of the supplementary plan,the General Questionnaire,the willingness / reality questionnaire,the difficulty scale,the satisfaction scale and the anxiety-depression scale were used.Research Results:1.The total Cronbach's Coefficient was 0.964,each dimension Coefficient was 0.863 ~ 0.950,the retest reliability was 0.990(P<0.05),the content validity of I-CVI was 0.66 ~ 1.00,and the S-CVI/Ave was 0.92,the total variance of the questionnaire was 77.021%.By using principal component analysis and maximum variance orthogonal rotation method to analyze factor load,4common factors were extracted,and the common factors were named as disease profile,disease treatment,disease follow-up,disease and life.2.The common decision-making knowledge base of 26 items was obtained by Delphi.The expert Judgment Criterion Coefficient(Ca)was 0.925 and 0.930 respectively.The expert Authority Coefficient(Cr)was 0.842 and 0.855 respectively.The mean score of item importance was between 4.25 and 4.85,and the Coefficient of variation was between 7.5% and 21.47%.TheKendall Coefficient(W)of the degree of coordination of expert opinions is 0.293 and 0.445 respectively.3.In the applied study,there was no significant difference in the general data between the two groups,and by comparing the two groups,the actual participation in the joint decision-making,the decision-making dilemma of the patients,there were significant differences in the four dimensions of satisfaction questionnaire: Information,communication coordination,decision-making,total satisfaction and confidence(P<0.05).The analysis shows that the median of 3.000 in intervention group is higher than that of 2.500 in control group.The median number of decision-making difficulties was 32.031 in the intervention group and 73.438 in the control group.In satisfaction,the intervention group was significantly higher than the control group.After intervention,the degree of co-decision-making participation of intervention group was higher than that of Control Group,and patients' decision-making dilemma was obviously lower.The comparison within the Control Group showed that there was no significant difference except decision-making dilemma(P<0.05).In the intervention group,the median before intervention was 2.000,which was significantly lower than the median after intervention.The median before intervention was 78.125,which was significantly higher than that after intervention was 32.031.The intervention group showed significant differences in the actual participation degree,decision-making dilemma and Decision Satisfaction.The results showed that the co-decision support scheme for patients with Crosne's disease had some effect on increasing the actual participation degree,reducing the difficulty of decision-making,and increasing the satisfaction degree.Research Conclusion:This study focused on the individualized needs of CD patients to participate in co-decision-making.After strict reliability and validity test and expert inquiry,the co-decision-making assistant scheme was formed and applied in patients with Crosne's disease.It was proved that the assistant scheme could improve the degree of patients' participation in decision-making and reduce the decision-making difficulty.Among them,the knowledge requirement questionnaire can accurately assess the most needed decision-making knowledge of patients,and then make use of the common decision-making knowledge base to carry out targeted education,so that patients can participate in the common decision-making more smoothly,forpatients to actively participate in their own disease management and improve treatment compliance to lay a good foundation.