原发性房角关闭病人激光治疗决策辅助工具的研制

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Development of a decision aid to support decision making in laser therapy for patients with primary angle closure

Abstract  Objective：Develop a decision aid for laser therapy of patients with primary angle closure based on the shared decision-making concept to provide professional decision support for patients，improve the quality of decision-making and promote shared decision⁃making.Methods：Based on the Ottawa Decision Support Framework and International Patient Decision Aids Standard，the first draft of the laser therapy decision aid for patients with primary angle closure was developed through literature analysis.Through two rounds of expert consultation，integrating input from experts in the fields of glaucoma clinical medicine，ophthalmic nursing and public health management，resulting in a revised version.Clinical investigation was conducted to understand the evaluation of the acceptability of the tool by patients and medical staffs，and the tool was further refined to form the final draft.Results：A total of 19 experts completed this expert consultation with a positivity of 95.0% and an authority factor of 0.918.After two rounds of expert consultation，the Kendall's W for each indicator of the tool were 0.131，0.224 and 0.187 respectively（P<0.05），indicating that the experts were more accepting of the content of the tool and had a good degree of harmonization of opinions.Clinical investigation found a high level of acceptance of the tool by patients and medical staffs，who found it easy to understand and use，and able to assist in decision-making.The final laser therapy decision aid for patients with primary angle closure contains 7 primary indicators：clarify decision，assess decision needs，provide information，analyse risk-benefit，clarify values，guide decision making and confirm decision，15 secondary indicators and 32 tertiary indicators.Conclusion：The laser therapy decision aid for patients with primary angle closure is scientifically and clinically applicable，and provides a scientific and effective means of supporting patient participation in their own safety management and achieving shared decision⁃making.

Keywords  primary angle closure； laser peripheral iridotomy； patient decision aid； shared decision⁃making

摘要  目的：研制基于共同决策理念的原发性房角关闭病人激光治疗决策辅助工具，为病人提供专业的决策支持，提高决策质量，促进医患共同决策。（剩余14586字）