Full
Outline
To systematically analyze the influencing factors of doctor-patient decision-making for terminally ill patients in the intensive care unit(ICU) based on the consolidated framework for implementation research(CFIR),so as to provide a basis for constructing localized nursing practice strategies.
Using purposive sampling method,a total of 28 medical staff in the intensive care unit and 12 family members of terminally ill patients from a tertiary grade A hospital in Sichuan province were selected for semi-structured interviews from March to June 2024.Directed content analysis combined with CFIR was used for coding analysis and rating.
Four core themes are identified:the characteristics of shared decision-making sources of shared decision-making,relative advantages of shared decision-making,complexity of shared decision-making,costs of shared decision-making),external factor domains(local perspectives,local conditions,policies and regulations,external pressures),internal factor domains(structural features,culture,innovation incentive mechanisms,available resources,knowledge and information acquisition),and individual characteristics(needs,capabilities,opportunities,motivation).The rating identified 13 barrier factors,3 facilitating factors,and 1 neutral factor.
The implementation of shared decision-making is influenced by multiple dimensions,such as culture,policies,resources,and capabilities.It is urgent to establish localized shared decision-making implementation strategies,develop decision-support tools for family members,and jointly reform medical insurance,ethics,and legal policies to improve the quality of end-of-life decision-making.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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