患者参与决策与医学新技术使用行为的关联分析

Corelation Analysis of Physician-Patient Shared Decision-making and the Adoption of New Medical Technologies

目的研究我国医学新技术临床应用中的患者参与决策,分析患者参与决策对患者医学新技术使用行为的关联性及影响。方法采用横断面设计和分层整群抽样方法,选取上海市、福建省、四川省18家医院临床科室的患者进行调研,调查问卷为自主设计,借鉴国外SDM-Q-9量表,应用LIKERT五分量表赋值进行logistic回归分析等。结果共调查了来自18家医院临床科室的554名患者,患者SDM-Q-9量表总得分为(34.66±7.314)分,单条目得分为3.74~3.95分,聚类分析显示,310名(占64.32%)患者的量表得分为"较高";患者SDM-Q-9得分对患者是否使用医学新技术有统计学意义(P<0.05),对患者决策满意度有统计学意义(P<0.05),患者满意度对患者是否使用新技术也有统计学意义(P<0.05),此三者间两两相关。结论医学新技术临床应用中患者参与决策的实际有效性仍有待研究;患者参与决策正向影响患者决策满意度,并影响患者是否使用医学新技术。建议加强合理的患者参与,适度把握新技术监管,以提高患者满意度,促进医学技术创新发展与适宜推广。

Objective To study the corelation between patients＇ participation in decision-making and patients＇ adoption of new medical technology in China. Methods Cross-sectional survey and stratified cluster sampling method were conducted among patients from 18 hospitals in Shanghai City,Fujian Province and Sichuan Province. Questionnaire was developed with referring to SDM-Q-9 scale. Data were analyzed with the LIKERT method,corelation analysis and logistic regression. Results A total of 554 patients from various departments of 18 hospitals in 5 cities were investigated. The total score of SDM-Q-9 was（34.66±7.314）,and 310（64.32%） patients pecieved better involvement in decision-making. SDM-Q-9 score had significant influence on patients＇ adoption of technology（P〈0.05）,and on patient satisfaction（P〈0.05）,while patient satisfaction also affects patients＇ adoption（P〈0.05）. Conclusion Patients,actual level of involvement in decision-making in clinical application of new medical technology remains to be studied.Patients＇ participation in decision-making affects patients＇ satisfaction,and have influence on patients＇ adoption of new medical technology. It is suggested to promote the patients＇ reasonable participation in decision making,and to strengthen the supervision to new medical technology.