目的 调查膀胱癌患者尿流改道术式决策冲突现状并分析其影响因素，为构建决策辅助方案提供依据。 方法 2021年7月至2022年4月，采用便利抽样法，选取在某三级甲等医院就诊的120例膀胱癌患者为研究对象，使用一般资料调查表、决策冲突量表、决策自我效能量表对其进行调查。 结果 膀胱癌患者决策冲突量表得分为(51.51±16.66)分，92.5%的患者存在决策冲突，其中高水平冲突高达77.5%。决策自我效能量表得分为(56.67±9.13)分，与患者决策冲突水平呈负相关(r=-0.554，P＜0.001)。多元线性回归分析结果显示，年龄、文化程度、家庭月收入、肿瘤分期、决策自我效能是决策冲突的影响因素（均P＜0.001），解释总变异的63.5%。 结论 膀胱癌患者尿流改道术式决策冲突较高，且受多种因素影响。医务人员应早期识别患者的决策冲突，为患者提供信息支持及心理支持，引导其采取积极的应对方式，提升决策自我效能以减低患者决策冲突，优化决策质量。

Objective To explore the decision conflicts in patients with bladder cancer undergoing urinary diversion and analyze its influencing factors,so as to provide a reference for a decision aid program. Methods From July 2021 to April 2022,120 patients with bladder cancer in a tertiary A hospital were selected by the convenience sampling method and surveyed using the General Information Questionnaire,the Decision Conflict Scale and the Decision Self-Efficacy Scale. Results The decision conflict score of bladder cancer patients was (51.51±16.66).92.5% of the selected patients had experienced decision conflicts,and the high level conflict accounted for 77.5%.The score of Decision Self-Efficacy Scale was (56.67±9.13),which was negatively correlated with the level of decision conflict(r=-0.554,P＜0.001).Multiple linear regression analysis showed that age,education,monthly household income,tumor stage,and decision-making self-efficacy were the influential factors for decision-making conflict (all P＜0.001),explaining 63.5% of the total variance. Conclusions Decision conflicts for urinary diversion in patients with bladder cancer are high and influenced by multiple factors.Medical staff should identify the conflicts in the early stage,provide patients with information support and psychological support,guide them to adopt positive coping methods,and enhance decision self-efficacy,so as to reduce the decision conflicts and optimize decision quality.

R473.58