Chegini Zahra, Islam Sheikh Mohammed Shariful
Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
J Patient Exp. 2021 Oct 16;8:23743735211049661. doi: 10.1177/23743735211049661. eCollection 2021.
Patient participation in care decisions is facilitated by shared-decision-making (SDM). This study, therefore, aims to explore the impact of patient's trust in physicians, emotional support, informational support, and tendency to excuse on SDM. A cross-sectional study was conducted at the medical-surgical wards of 6 similar-sized public hospitals in Tabriz, northwest Iran, using a self-administered questionnaire, with 321 cases collected from October to December 2019. The structural equation modeling (SEM) analysis was used to test the hypothetical model. Using the SEM approach, the findings fully confirmed the study hypothesis, and patients' trust in physician (Beta = -0.44), emotional support (Beta = 0.29), tendency to excuse (Beta = 0.18), and informational support (Beta = 0.58) predicted the inpatient's SDM behavior ( = 0.65, goodness-of-fit index = 0.902). To improve patient outcomes, physicians might advise incorporating techniques such as improving patient trust, informational and emotional supports to improve SDM. Improving the psychosocial skills of physicians also seems to be essential to help patients express their concerns.
共同决策（SDM）有助于患者参与医疗决策。因此，本研究旨在探讨患者对医生的信任、情感支持、信息支持以及宽容倾向对共同决策的影响。在伊朗西北部大不里士市6家规模相近的公立医院的内科和外科病房进行了一项横断面研究，采用自填式问卷，于2019年10月至12月收集了321份病例。采用结构方程模型（SEM）分析来检验假设模型。使用SEM方法，研究结果完全证实了研究假设，患者对医生的信任（β = -0.44）、情感支持（β = 0.29）、宽容倾向（β = 0.18）和信息支持（β = 0.58）预测了住院患者的共同决策行为（χ² = 0.65，拟合优度指数 = 0.902）。为了改善患者的治疗效果，医生可能会建议采用一些技巧，如提高患者信任度、提供信息和情感支持以改善共同决策。提高医生的心理社会技能对于帮助患者表达担忧似乎也至关重要。
