Nuwagaba Julius, Olum Ronald, Bananyiza Ali, Wekha Godfrey, Rutayisire Meddy, Agaba Keneth Kato, Chekwech Gaudencia, Nabukalu Jalidah, Nanyonjo Genevieve Gloria, Namagembe Robinah, Nantongo Sylvia, Lubwama Margaret, Besigye Innocent, Kiguli Sarah
School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Patient Prefer Adherence. 2021 May 26;15:1133-1140. doi: 10.2147/PPA.S302784. eCollection 2021.
Patient autonomy and participation have a significant impact on patient satisfaction and compliance with treatment. We aimed to establish and describe the level of shared decision-making (SDM) among the patients in a developing country. Uganda is a low resource country with a 2019 GDP of 35.17 billion US dollars. In some regions, over 60% of Ugandans live below the national poverty line and most of them depend on the underfunded health care system.
A cross-sectional, quantitative study was carried out among the outpatients attending Kisenyi Health center IV, Kampala, Uganda. An interviewer-administered questionnaire with a 5-point Likert scale was used to assess patients' SDM. All statistical analysis was performed using STATA 15 software.
A total of 326 patients participated in this study. Majority of the participants were females (n=241, 73.9%) and aged 18-35 years (n=218, 66.9%). Only 22 (7%) of the participants knew the name of their consulting doctor. Most of the participants, 84% were given enough time to narrate their symptoms. Overall, only 11.3% (n=37) of the participants had adequately participated in SDM. The overall mean score of participation in SDM was 2.7 (SD:0.8). Participants who knew the name of their consulting doctor were approximately 11 times more likely to participate in SDM (OR: 10.7, 95% CI: 4.2-27.0, P<0.0001).
The majority of patients attending Kisenyi Health Center IV did not adequately participate in SDM. Continued medical education should be organized for healthcare professionals to promote SDM.
患者自主权和参与度对患者满意度及治疗依从性有重大影响。我们旨在确立并描述一个发展中国家患者间共同决策（SDM）的水平。乌干达是一个资源匮乏的国家，2019年国内生产总值为351.7亿美元。在一些地区，超过60%的乌干达人生活在国家贫困线以下，他们中的大多数依赖资金不足的医疗保健系统。
在乌干达坎帕拉基森伊第四健康中心就诊的门诊患者中开展了一项横断面定量研究。采用一份由访谈员实施的、具有5级李克特量表的问卷来评估患者的共同决策情况。所有统计分析均使用STATA 15软件进行。
共有326名患者参与了本研究。大多数参与者为女性（n = 241，73.9%），年龄在18 - 35岁之间（n = 218，66.9%）。只有22名（7%）参与者知道他们咨询医生的姓名。大多数参与者（84%）有足够的时间讲述他们的症状。总体而言，只有11.3%（n = 37）的参与者充分参与了共同决策。共同决策参与度的总体平均得分为2.7（标准差：0.8）。知道咨询医生姓名的参与者参与共同决策的可能性大约高出11倍（比值比：10.7，95%置信区间：4.2 - 27.0，P < 0.0001）。
在基森伊第四健康中心就诊的大多数患者没有充分参与共同决策。应为医疗保健专业人员组织持续医学教育以促进共同决策。
