医患共同决策模式促进老年患者医患互信的效果调查

Investigation on the Effect of Doctor-patient Joint Decision-making Model in Promoting Mutual Trust Between Elderly Patients and Doctors

目的了解老年患者对不同决策伦理模式的感受及患者选择不同医疗决策模式的影响因素,探讨老年患者在就诊过程中临床决策模式及满意度的相关性。方法通过问卷调查方式,于2019年8月~11月对我院干部保健科、心血管内科、血液肿瘤科、微创外科等4个科室的住院老年患者进行问卷调查,分析老年患者对不同决策伦理模式的满意度以及影响患者选择不同医疗决策模式的因素。结果共发放问卷79份,回收有效问卷79份,有效回收率100.00%,调查对象均为60岁及以上老年患者;老年患者对不同医疗决策模式的满意度比较,差异无统计学意义(P>0.05),但医患共同决策模式的满意度分数最高;是否有住院经历及是否愿意自主决定的老年患者选择的医疗决策模式比较,差异有统计学意义(P<0.05);单因素分析显示,患者是否愿意自主决定治疗方式受年龄、身体状况、是否合并高血压及其他疾病、是否了解住院后的治疗情况及本次治疗方案的制定等因素有关。结论医师在面对高龄、身体状况自感一般、合并有高血压的患者或者对住院治疗比较了解的患者需更加注重医患双方充分沟通、共同决策,以达到较好的治疗目标。

Objective To understand the feelings of elderly patients on different decision-making ethical models and the influencing factors of patients choosing different medical decision-making models,and to explore the correlation between the clinical decision-making model and satisfaction degree of elderly patients during medical treatment.Methods A questionnaire survey was conducted on elderly patients hospitalized in the four departments of our hospital,including the Department of Cadre Health,Cardiovascular Medicine,Hematology Oncology,and Minimally Invasive Surgery,from August to November 2019,and analyzed the different decisions made by elderly patients.The satisfaction of the ethical model and the factors that influence patients to choose different medical decision-making models.Results A total of 79 questionnaires were issued and 79 valid questionnaires were returned,with an effective recovery rate of 100.00%.The subjects were all elderly patients aged 60 and above.There was no statistically significant difference in the satisfaction of elderly patients with different medical decision-making models(P>0.05).However,the doctor-patient joint decision-making model had the highest satisfaction score;whether there was hospitalization experience and whether the elderly patients were willing to decide independently,the difference was statistically significant(P<0.05);univariate analysis shows whether the patient was willing self-determination of treatment was related to factors such as age,physical condition,whether it was complicated with hypertension and other diseases,whether to understand the treatment after hospitalization,and the formulation of this treatment plan.Conclusion Physicians should pay more attention to full communication and joint decision-making between doctors and patients when facing patients with advanced age,normal physical condition,and hypertension,or patients who have a better understanding of hospitalization,in order to achieve better treatment goals.