慢性病患者参与医患共同决策影响因素的Meta分析

Influencing factors of participation in doctor-patient shared decision-making inpatients with chronic disease: a Meta-analysis

目的对慢性病患者参与医患共同决策的影响因素进行Meta分析,为提高慢性病患者共同决策参与率提供科学依据。方法系统检索中国知网、维普、万方、PubMed和Web of Science中英文数据库公开发表的有关慢性病患者参与医患共同决策影响因素的文献,利用Review Manager 5.4和Stata 13.0软件进行效应量合并。结果共检索到700篇文献,根据纳排标准,最终纳入17篇中英文文献。结果显示慢性病患者医患共同决策合并参与率为36.90%(28.80%~45.00%);年龄(OR=0.92,95%CI:0.82~0.99)、文化程度(OR=1.57,95%CI:1.24~1.99)、家庭人均月收入(OR=1.60,95%CI:1.12~2.28)、是否首次手术(OR=1.85,95%CI:1.27~2.70)、疾病相关知识了解(OR=0.98,95%CI:0.96~0.99)是影响慢性病患者参与共同决策的重要因素。结论慢性病患者医患共同决策参与率有待进一步提高,慢性病患者参与医患共同决策受多种因素影响,应对医患双方采取相应措施来提高共同决策参与率。

Objective To analyze the influencing factors of the participation of patients with chronic disease in doctor-patient shared decision-making by meta-analysis,and provide reference for improving the participation of patients with chronic disease in shared decision-making.Methods A systematic search was conducted on literature in Chinese and English databases including CNKI,VIP,Wangfang,PubMed,and Web of Science on the influencing factors of participation of patients with chronic disease in shared decision-making.The effects were merged using Review Manager 5.4 and Stata13.0.Results A total of 700 pieces of literature were retrieved,and 17 pieces of eligible Chinese and English literature were ultimately included.The rate of participation in shared decision-making of patients with chronic disease was 36.90%(28.80%~45.00%).Age(OR=0.92,95%CI:0.82~0.99),educational background(OR=1.57,95%CI:1.24~1.99),monthly income per capita(OR=1.60,95%CI:1.12~2.28),whether the first time to perform surgery(OR=1.85,95%CI:1.27~2.70),and disease-related knowledge(OR=0.98,95%CI:0.96~0.99)were important factors that affect the participation of patients with chronic disease in shared decision-making.Conclusion The participation rate of patients with chronic disease in doctor-patient shared decision-making needs to be further improved.The participation is influenced by multiple factors,and corresponding measures should be taken by both doctors and patients to increase the participation rate.