Dai Jingyao, Hua Yiting, Chen Yijie, Huang Jiali, Zhang Xiaoxian, Sun Yiwen, Chen Chen, Chen Yanyan, Zhou Kaijing
School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Patient Prefer Adherence. 2024 Jun 24;18:1311-1321. doi: 10.2147/PPA.S468452. eCollection 2024.
To explore 1) the level of shared decision-making (SDM) participation in intraocular lens (IOL) selection in cataract patients and the factors that influence this participation and 2) the relationships between preparation for decision-making (PrepDM)and the level of SDM participation and satisfaction with the decision (SWD). Provide guidance for improving SDM in ophthalmology.
176 cataract patients were asked to complete the PrepDM scale, the 9-item Shared Decision Making Questionnaire (SDM-Q-9) and the SWD instrument in IOL decision-making process. Multiple linear regression was used to analyze the influencing factors of the level of SDM. The Process program and bootstrap sampling method was used to test whether the level of participation in SDM was a mediating variable among the three.
The SDM-Q-9 median score was 77.78 (IQR 31.11-88.89). Patients with a history of surgery in the operative eye (=0.022) or PrepDM <60 points (<0.001) had lower SDM-Q-9 scores than patients with no history of surgery in the operative eye or PrepDM ≥60 points. Patients with an education level lower than primary school had lower SDM-Q-9 scores than patients with other education levels (<0.05). The PrepDM of cataract patients was positively correlated with the level of SDM (=0.768, <0.001) and with the SWD (=0.727, <0.001), and the level of SDM was positively correlated with the SWD (=0.856, <0.001). The level of SDM fully mediated PrepDM and SDW, with a mediating effect value of 0.128 and a mediating effect of 86.66% of the total effect.
The SDM of cataract patients involved in IOL selection was in the upper middle range. Education, history of surgery in the operated eye, and PrepDM were factors that influenced the level of SDM. The level of participation in SDM fully mediated the relationship between PrepDM and SWD.
探讨1）白内障患者在人工晶状体（IOL）选择中共同决策（SDM）的参与程度及其影响因素，以及2）决策准备（PrepDM）与SDM参与程度和决策满意度（SWD）之间的关系。为改善眼科领域的SDM提供指导。
176例白内障患者在人工晶状体决策过程中被要求完成PrepDM量表、9项共同决策问卷（SDM-Q-9）和SWD工具。采用多元线性回归分析SDM水平的影响因素。使用Process程序和Bootstrap抽样方法检验SDM参与程度是否为三者之间的中介变量。
SDM-Q-9中位数为77.78（四分位间距31.11 - 88.89）。术眼有手术史的患者（=0.022）或PrepDM<60分（<0.001）的SDM-Q-9得分低于术眼无手术史或PrepDM≥60分的患者。小学以下文化程度的患者SDM-Q-9得分低于其他文化程度的患者（<0.05）。白内障患者的PrepDM与SDM水平呈正相关（=0.768，<0.001），与SWD呈正相关（=0.727，<0.001），SDM水平与SWD呈正相关（=0.856，<0.001）。SDM水平完全中介了PrepDM和SDW，中介效应值为0.128，中介效应占总效应的86.66%。
参与人工晶状体选择的白内障患者的SDM处于中上等水平。文化程度、术眼手术史和PrepDM是影响SDM水平的因素。SDM参与程度完全中介了PrepDM与SWD之间的关系。
