营养师采用共同决策行为意向的社会心理因素：一项横断面调查。
Psychosocial factors of dietitians' intentions to adopt shared decision making behaviours: a cross-sectional survey.
机构信息
Research Centre, Centre hospitalier universitaire de Québec, Quebec City, Quebec, Canada.
出版信息
PLoS One. 2013 May 20;8(5):e64523. doi: 10.1371/journal.pone.0064523. Print 2013.
OBJECTIVES
While shared decision making (SDM) promotes health-related decisions that are informed, value-based and adhered to, few studies report on theory-based approaches to SDM adoption by healthcare professionals. We aimed to identify the factors influencing dietitians' intentions to adopt two SDM behaviours: 1) present dietary treatment options to patients and 2) help patients clarify their values and preferences.
METHODS
We conducted a cross-sectional postal survey based on the Theory of Planned Behaviour among 428 randomly selected dietitians working in clinical practice across the Province of Quebec, Canada. We performed descriptive analyses and multiple regression analyses to determine the variables that explained the variance in intention to perform the behaviours.
RESULTS
A total of 203 dietitians completed the questionnaire. Their ages were from 23 to 66 and they had been practising dietetics for 15.4±11.1 years (mean ± SD). On a scale from 1 to 7 (from strongly disagree to strongly agree), dietitians' intentions to present dietary treatment options and to clarify their patients' values and preferences were 5.00±1.14 and 5.68±0.74, respectively. Perceived behavioural control (β = 0.56, ρ<0.0001), subjective norm (β = 0.16, ρ<0.05), and moral norm (β = 0.22, ρ<0.0001), were the factors significantly predicting the intention to present dietary treatment options, while perceived behavioural control (β = 0.60, ρ<0.0001), attitude (β = 0.20, ρ<0.05), and professional norm (β = 0.22, ρ<0.001), significantly predicted the intention to help patients' clarify their values and preferences.
CONCLUSION
Our results showed that dietitians intend to adopt the two SDM behaviours studied. Factors influencing intention were different for each behaviour, except for perceived behavioural control which was common to both behaviours. Thus, perceived behavioural control could be a key factor in interventions aiming to encourage implementation of SDM by dietitians.
目的
尽管共享决策（SDM）促进了基于信息、价值观和坚持的与健康相关的决策，但很少有研究报告医疗保健专业人员采用基于理论的 SDM 方法。我们旨在确定影响营养师采用两种 SDM 行为的因素：1）向患者介绍饮食治疗方案，2）帮助患者澄清其价值观和偏好。
方法
我们在加拿大魁北克省临床实践中随机选择的 428 名营养师中进行了基于计划行为理论的横断面邮寄调查。我们进行了描述性分析和多元回归分析，以确定解释行为意向差异的变量。
结果
共有 203 名营养师完成了问卷。他们的年龄为 23 至 66 岁，从事营养师工作的时间为 15.4±11.1 年（平均值±标准差）。在 1 到 7 的量表上（从非常不同意到非常同意），营养师提出饮食治疗方案和澄清患者价值观和偏好的意愿分别为 5.00±1.14 和 5.68±0.74。感知行为控制（β=0.56，ρ<0.0001）、主观规范（β=0.16，ρ<0.05）和道德规范（β=0.22，ρ<0.0001）是显著预测提出饮食治疗方案意愿的因素，而感知行为控制（β=0.60，ρ<0.0001）、态度（β=0.20，ρ<0.05）和专业规范（β=0.22，ρ<0.001）则显著预测帮助患者澄清价值观和偏好的意愿。
结论
我们的结果表明，营养师打算采用研究中的两种 SDM 行为。影响意向的因素因行为而异，除了感知行为控制对两种行为都适用外。因此，感知行为控制可能是鼓励营养师实施 SDM 的干预措施的关键因素。
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