乳腺癌手术决策辅助护士应用决策辅助工具的体验 [中文引用][英文引用]

目的  了解乳腺癌手术决策辅助护士应用决策辅助工具的体验，明确优势与不足，提出优化建议，促进工具在临床落地应用与推广。方法  应用描述现象学研究方法，采用目的抽样法，于 2024 年 12 月— 2025 年 9 月，选取 23 名决策辅助护士作为研究对象，进行半结构式访谈，采用 Colaizzi 7 步分析法分析资料。结果  共提炼出 3 个主题和 11 个亚主题：主题 1：决策辅助工具对患者个体层面的多维赋能效应（增加患者对乳腺癌手术知识的认知度，厘清价值观；减轻患者手术选择决策的迷茫，促进决策参与意愿）。主题 2：决策辅助工具临床应用的多维阻碍因素（不融洽的护患关系；护士自身专业知识能力不足；决策辅助工具的形式局限与内容窄化；乳腺癌患者乳房再造的羞耻感与隐私保护需求；住院日缩短背景下决策辅助的前移需求与现实困境）。主题 3：决策辅助工具的优化策略（进行决策辅助护士同质化培训；丰富决策辅助工具呈现形式；协助不同的患者选择适宜的决策辅助工具；建立决策辅助工具资源库）。结论  决策辅助护士对决策辅助工具的整体认可度较高，但目前决策辅助工具还需通过内容、形式等方面的优化，定期开展决策辅助工具使用技巧培训，持续优化使用流程，进而为其在临床中的广泛应用提供有力支持。

Objective To understand the experience of breast cancer decision support nurses in application of decision support tools，identify the advantages and shortcomings，propose targeted optimisations and promote the clinical implementation and popularisation of the tools. Methods Using the methods of descriptive phenomenological research and purposive sampling，23 decision support nurses were selected as the research participants between December 2024 and September 2025. Semi-structured interviews were conducted，and the data were analysed by the Colaizzi method. Results The findings from the study participants were categorised into ?3 main themes and 11 sub-themes. Theme 1：the multidimensional empowering effect of decision support tools at the level of individual patient（increase awareness of the knowledge of breast cancer surgery and clarifying the values；reduce the confusion of in decision-making for surgery and promote the willingness to participate in decision-making）. Theme 2：multidimensional barriers to the clinical application of decision support tools（disharmonious nurse-patient relationship；insufficient professional knowledge and ability among nurses；limited format and content narrowing of decision support tools；feelings of shame in patients regarding breast reconstruction and the needs for protection of privacy；the need to advance decision support and practical dilemmas in the context of shortened hospital days）. Theme 3：optimisation strategy for decision support tools（homogenisation training for decision support nurses；enrich the presentation formats of decision support tools；assist individuals in selection of appropriate decision support tools；establish a resource library of decision support tool）. Conclusion Decision support nurses have a high overall recognition of decision support tools. However，current decision support tools are required to be further optimised in terms of content and format. Regular training on the use of decision support tools should be carried out，and the application process should be continuously optimised to provide strong support for the use of decision support tools in clinical practice.