Huang Rong-Chong, Song Xian-Tao, Zhang Dong-Feng, Xu Jia-Ying, Boehmer Kasey R, Leppin Aaron A, Gionfriddo Michael R, Ting Henry H, Montori Victor M
Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Chronic Dis Transl Med. 2019 Jun 17;5(2):105-112. doi: 10.1016/j.cdtm.2019.05.001. eCollection 2019 Jun.
This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM).
From May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids (DAs) during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann-Whitney tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario.
Of the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM.
Most young Chinese clinicians want to participate in SDM. However, they state the main barriers to perform SDM are lack of experience and time. The educational intervention about SDM that exposes clinicians to DAs was found to increase their receptivity.
本研究评估中国临床医生对于参与共同决策（SDM）的态度和偏好。
2014年5月至2015年5月，招募了来自两家医院的200名中国临床医生，以完成一项关于他们对SDM态度的调查。我们在对中国年轻临床医生进行SDM教育干预前后，通过面对面访谈的方式进行了调查。要求临床医生对SDM表示同意的程度。他们还给出了在SDM过程中使用决策辅助工具（DAs）的困难程度。记录了SDM干预前后每个问题回答范围的变化。使用JMP 6.0软件分析回答变化的频率。根据数据类型，使用卡方检验和曼-惠特尼检验对数据进行统计学分析。使用多元逻辑回归来测试那些与每种情景下对一种方法的偏好显著且独立相关的因素。
在抽取的200名中国年轻临床医生中，59.0%的人在接受教育或观看DAs之前表示倾向于SDM并希望参与其中，在观看了关于他汀类药物选择的SDM过程示例视频后，这一比例增加到了69.0%。然而，28.5%的受访者仍表示，在他们目前的临床实践中，他们代表患者做出临床决策。那些拒绝使用DAs的临床医生表示，在中国实施SDM或使用DAs的主要障碍是缺乏时间和对SDM的了解。
大多数中国年轻临床医生希望参与SDM。然而，他们表示实施SDM的主要障碍是缺乏经验和时间。发现让临床医生接触DAs的关于SDM的教育干预提高了他们的接受度。
