基于患者视角的医疗决策模式及其影响因素研究

Research on Medical Decision-making Model and Its Influencing Factors from Patients’ Perspective

了解患者对医疗决策模式的选择倾向,探讨其影响因素及相关性。对广州地区六家医院的门诊和住院患者共450例进行问卷调查。结果,15.42%的患者倾向于积极决策,45.06%的患者倾向于共享决策,39.52%的患者倾向于消极决策,且大部分患者倾向于家属参与决策。年龄(OR=0.759,P=0.041)和学历(OR=0.699,P=0.019)对患者参与医疗决策意愿的影响具有统计学差异,年龄越大、学历越高的患者倾向于主动型决策。多数患者倾向于共享决策,共享决策有助于临床决策过程的改善。要积极发挥医生在患者参与决策中的重要作用,以及家属的“支持”与“矫正”功能。

This study aimed to understand patients'preference for medical decision-making mode,and to explore its influencing factors and correlation.A total of 450 outpatients and inpatients from six hospitals in Guangzhou were investigated by questionnaires.The results showed that 15.42%of patients preferred positive decision-making,45.06%of patients preferred shared decision-making,39.52%of patients preferred negative decision-making,and the most of patients preferred family-involvement decision-making.Age(OR=0.759,P=0.041)and education(OR=0.699,P=0.019)have statistical differences in the impact of patients'willingness to participate in medical decision-making.The older the patients,the higher their educational backgrounds,the more proactive they tended to make decisions.Most of the patients preferred shared decision-making,which is helpful to improve the clinical decision-making process.We should actively play the important roles of doctors in patients'participation in decision-making,as well as the"support"and"correction"functions of family members.