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中国住院患者参与医疗决策偏好的最佳-最差尺度调查

Best-Worst Scaling Survey of Inpatients' Preferences in Medical Decision-Making Participation in China.

作者信息

Sun Tao, Chen Hanlin, Gao Yuan, Xiang Yingru, Wang Feng, Ni Ziling, Wang Xiaohe, Huang Xianhong

机构信息

Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou 311121, China.

The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.

出版信息

Healthcare (Basel). 2023 Jan 21;11(3):323. doi: 10.3390/healthcare11030323.

Abstract

This study assesses inpatients' preferences for participating in medical decision-making and determines the factors' rankings in order of importance and whether they vary for respondents with different characteristics. Case 1 best-worst scaling (BWS) was used for the study design. Thirteen attributes influencing inpatient medical decision-making participation were identified based on a literature review and interview results. A balanced incomplete block design was used to form choice sets for the BWS questionnaire for a cross-sectional study examining inpatients' preferences for participating in medical decision-making. Based on results from 814 inpatient participants, the three most important factors influencing inpatients' medical decision-making participation were inpatients' trust in physicians, physicians' professional expertise, and physicians' attitudes. The mixed logit model results reflect the significant heterogeneity in respondents' preferences for shared decision-making. To facilitate resource allocation, improve the physician-patient relationship, and encourage patient decision-making participation more actively and effectively, decision-makers should emphasize patients' trust, enhance physicians' ability to diagnose and treat diseases, and improve their attitudes toward providing care and communication from the perspectives of patients, physicians, and the social environment. Further research is needed on the heterogeneity of patients' preferences for participating in medical decision-making and how to improve patient participation.

摘要

本研究评估住院患者参与医疗决策的偏好,确定各因素按重要性排序的情况,以及不同特征的受访者的偏好是否存在差异。本研究设计采用案例1最佳-最差标度法(BWS)。基于文献综述和访谈结果,确定了影响住院患者参与医疗决策的13个属性。采用平衡不完全区组设计为BWS问卷形成选择集,用于一项横断面研究,以考察住院患者参与医疗决策的偏好。基于814名住院患者参与者的结果,影响住院患者参与医疗决策的三个最重要因素是患者对医生的信任、医生的专业知识和医生的态度。混合逻辑模型结果反映了受访者对共同决策偏好的显著异质性。为了促进资源分配、改善医患关系,并更积极有效地鼓励患者参与决策,决策者应从患者、医生和社会环境的角度强调患者的信任、提高医生的疾病诊治能力,并改善他们提供护理和沟通的态度。需要进一步研究患者参与医疗决策偏好的异质性以及如何提高患者参与度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0d4/9914008/f0b868697bf2/healthcare-11-00323-g0A1.jpg

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