Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
BMC Oral Health. 2022 Sep 5;22(1):385. doi: 10.1186/s12903-022-02420-x.
Shared decision-making is defined as the process by which physicians and informed patients make a shared medical decision, taking into account the preferences and values of the patients. It is well known that shared decision-making practices improve both clinicians' and patients' satisfaction and lead to better treatment outcomes. The aim of the study was to assess associations between patients' roles in decision-making, health literacy levels, and treatment outcomes of temporomandibular disorders (TMDs).
In total, 131 participants were enrolled. Participants underwent interview and physical examination at baseline and six months after TMD management. TMD was diagnosed according to Diagnostic Criteria/TMD criteria. Myofascial trigger points were bilaterally evaluated in the two masticatory muscles including the temporalis and masseter muscles. The roles that participants preferred to play or had perceived during decision-making and their health literacy levels were assessed using Control Preferences Scale and Newest Vital Sign, respectively.
Participants who perceived themselves as occupying active roles in decision-making showed higher health literacy levels than those with passive perceived roles. Participants with appropriate health literacy showed higher perceived participation levels in decision-making than did those with limited health literacy. The extent of subjective symptomatic improvement after six months of treatment showed significant associations with perceived role in decision-making, despite lack of significant relationships between perceived role in decision-making and the extent of improvement of objective parameters.
Active participation of patients in decision-making improves the satisfaction but limited health literacy constitutes barriers to effective patient engagement during TMD management.
共同决策是指医生和知情患者共同做出医疗决策的过程，同时考虑患者的偏好和价值观。众所周知，共同决策实践可以提高医患双方的满意度，并带来更好的治疗结果。本研究旨在评估患者在决策中的角色、健康素养水平与颞下颌关节紊乱（TMD）治疗结果之间的关系。
共纳入 131 名参与者。在 TMD 管理后，参与者在基线和 6 个月时接受了访谈和体格检查。根据诊断标准/TMD 标准诊断 TMD。在颞肌和咬肌这两块咀嚼肌中双侧评估肌筋膜触发点。使用控制偏好量表和最新生命体征分别评估参与者在决策中偏好或感知的角色以及他们的健康素养水平。
在决策中自我感知为积极角色的参与者表现出比被动感知角色更高的健康素养水平。具有适当健康素养的参与者在决策中的感知参与度高于健康素养有限的参与者。尽管决策中感知到的角色与客观参数改善的程度之间缺乏显著关系，但六个月治疗后的主观症状改善程度与决策中感知到的角色显著相关。
患者积极参与决策可以提高满意度，但有限的健康素养会阻碍 TMD 管理过程中患者的有效参与。
