多囊卵巢综合征患者参与决策的影响因素研究  

Influencing Factors of Polycystic Ovarian Syndrome Patients'Participation in Shared Decision-making

作　　者：郭旭芳 刘欢[1] 吴丽萍[2] 高川[1] 何仲[1] GUO Xufang;LIU Huan;WU Liping;GAO Chuan;HE Zhong(School of Humanities and Social Sciences,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;School of Nursing,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院人文和社会科学学院,北京市100730 [2]中国医学科学院北京协和医学院护理学院,北京市100730

出　　处：《中国全科医学》2021年第21期2685-2690,共6页Chinese General Practice

摘　　要：背景随着医疗模式的发展,共同决策成为促进医疗卫生事业发展的关键举措。深入了解多囊卵巢综合征(PCOS)患者参与决策的态度和实际情况有利于帮助患者做出更加满意的临床决策。目的了解PCOS患者参与决策的倾向,并探讨其影响因素。方法选取2020年4—6月于北京协和医院妇科内分泌中心、云南省第一人民医院生殖妇科就诊的PCOS患者为研究对象,调查其一般资料,并采用决策倾向性量表(CPS)评价患者决策参与倾向和实际决策情况。采用单因素分析和多因素Logistic回归分析探究PCOS患者参与决策的影响因素。结果本研究共发放问卷240份,回收问卷240份,其中有效问卷234份,有效回收率为97.5%(其中云南省有效问卷119份,北京市有效问卷115份)。234例患者中决策参与倾向主动型12例(5.1%),合作型153例(65.4%),被动型69例(29.5%);实际决策情况主动型13例(5.6%),合作型85例(36.3%),被动型136例(58.1%)。两所三甲医院PCOS患者决策参与倾向与实际决策情况比较,差异均有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,文化程度〔OR=17.840,95%CI(6.175,51.539)〕、家庭月收入〔OR=3.074,95%CI(1.528,6.144)〕是PCOS患者决策参与倾向的影响因素(P<0.05);文化程度〔OR=4.529,95%CI(2.468,8.311)〕、家庭月收入〔OR=1.461,95%CI(1.045,2.044)〕是PCOS患者实际决策情况的影响因素(P<0.05)。结论多数PCOS患者参与决策意识积极,但是实际参与程度低。文化程度较高、家庭月收入高的患者更愿意参与决策并且更容易真正参与决策。因此,医患双方应该正确认识并运用共同决策模式,形成有效沟通,一同做出更加满意的临床决策,减少决策遗憾。Background Shared decision-making has become a key initiative for healthcare development along with the advances in healthcare delivery models.Deep understanding of polycystic ovarian syndrome(PCOS)patients'attitude toward and real involvement in decision-making will help the patients to make more satisfactory clinical decisions.Objective To explore PCOS patients'preferences for participation in shared decision-making and associated factors.Methods PCOS patients were selected from the gynecological endocrinology center of Peking Union Medical College Hospital,and the reproductive gynecology department of the First People's Hospital of Yunnan from April to June 2020.An investigation was conducted to collect their demographic information,and preferences for participation and real involvement in shared decision-making using a selfdeveloped demographic information questionnaire,and the Chinese version of Control Preferences Scale,respectively.Univariate and multivariate Logistic regression analyses were used to identify the influencing factors of patients'participation in decisionmaking.Results A total of 240 cases attended the investigation,and 234(97.5%)of them(including 119 from Yunnan and 115 from Beijing)handed in responsive questionnaires were finally included.The rates of respondents preferring an active role,collaborative role,and passive role in shared decision-making were 5.1%(12/234),65.4%(153/234),and 29.5%(69/234),respectively.The rates of respondents actually playing an active role,collaborative role,and passive role in shared decisionmaking were 5.6%(13/234),36.3%(85/234),and 58.1%(136/234),respectively.The respondents from Beijing showed significant differences in their preferences for and real involvement in shared decision-making,so did those from Yunnan(P<0.01).Multivariate Logistic regression analysis showed that education level〔OR=17.840,95%CI(6.175,51.539)〕,average monthly household income〔OR=3.074,95%CI(1.528,6.144)〕influenced PCOS patients'preferences for participation in shared decisi

关 键 词：多囊卵巢综合征 共同决策 病人参与 影响因素分析 

分 类 号：R711.75[医药卫生—妇产科学] R395[医药卫生—临床医学]