心血管疾病介入治疗患者参与临床决策期望及实际参与程度研究

Study on Expected and Actual Participation in Clinical Decision-making Among Patients Undergoing Interventional Therapy for Cardiovascular Diseases

目的了解心血管疾病介入治疗患者临床决策参与期望及实际参与程度现状并分析其影响因素,旨在为促进患者参与临床决策提供理论依据。方法选取2021年11月至2022年4月收治于同济大学附属东方医院的240例心血管疾病介入治疗患者作为调查对象,采用“患者参与临床决策期望量表”及“患者参与治疗决策问卷”对其进行调查;并通过单因素分析、多元线性回归分析和多元logistic回归分析,探索患者参与临床决策的影响因素。结果心血管疾病介入治疗患者参与临床决策期望总得分为(50.62±10.33)分,临床决策实际参与程度高者占19.17%,参与程度低者占80.83%。多元线性回归分析显示,学历、婚姻状况、生育情况和是否首次接受介入治疗是患者参与临床决策期望的主要影响因素,可解释总变异的27.00%。多元logistic回归分析显示,学历、是否知晓诊断名称、是否首次接受介入治疗可影响患者实际参与临床决策的程度。结论心血管疾病介入治疗患者参与临床决策期望较高,但实际参与程度偏低;学历、是否首次接受介入治疗等因素会影响其临床决策参与期望和实际参与情况。

Objective To understand the expected and actual participation in clinical decision‑making among patients undergoing interventional therapy for cardiovascular diseases,and analyze its influencing factors,aiming to provide theoretical support for enhancing patient participation in clinical decision‑making.Methods A total of 240 patients were selected who underwent interventional therapy for cardiovascular diseases at Shanghai East Hospital Affiliated to Tongji University from November 2021 to April 2022.They were investigated using the"Patient Expectation for Participation in Medical Decisionmaking Scale"and the"Questionnaire Measuring Patient Participation in Medical Decision‑making".The influencing factors of patient participation in clinical decision‑making were explored by univariate analysis,multivariate linear regression analysis and multivariate logistic regression analysis.Results The total score of expectation for participation in clinical decision‑making was(50.62±10.33)points in patients undergoing interventional therapy for cardiovascular diseases.The actual participation was high in 19.17%of the patients and low in 80.83%.The multivariate linear regression analysis showed that patient expectation for participation in clinical decision‑making was influenced by education level,marital status,fertility status and whether they were first receiving interventional therapy,which can explain 27.00%of the total variation. The multivariate logistic regression analysis showed that the actual participation of patients inclinical decision ‑ making was influenced by education level, whether they knew the name of theirdiagnosed diseases, and whether they were first receiving interventional therapy.Conclusion Patientsundergoing interventional therapy for cardiovascular diseases exhibit a high expectation for participationin clinical decision ‑ making, yet their actual participation is limited. Their expected and actualparticipation in clinical decision‑making was influenced by education level and whether they were firstreceiving interventional therapy.