Department of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Department of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore.
J Hosp Infect. 2024 Sep;151:109-115. doi: 10.1016/j.jhin.2024.07.006. Epub 2024 Jul 18.
Half of hospitalized patients receive antibiotics, but they are rarely involved in shared decision making (SDM) on antibiotic therapy. We sought to understand the association between patient empowerment and their involvement in SDM on antibiotic therapy.
From March 2021 to April 2022, we conducted a cross-sectional survey on hospitalized patients receiving antibiotic therapy for ≥1 day in a 1600-bed adult general hospital in Singapore. The questionnaire included seven items (five-point Likert scale) on involvement in SDM from SDM-Q-9 and 10 items (four-point Likert scale) on patient empowerment from HCEQ-10. A multi-variable logistic regression model was constructed to assess for independent associations between the three constructs of patient empowerment and involvement in SDM on antibiotic therapy.
Of 636 hospitalized patients, mean age was 57.6 (SD 15.5) years, 61% were males and 37% had tertiary-level education. The majority (90%) were aware that they were on antibiotic therapy, but only 11% of them knew the name of the antibiotic given. After adjusting for age, gender, ethnicity, educational level, and duration of hospital stay, patients with a high-level of involvement in decisions (adjusted odds ratio (AOR) 3.63, 95% confidence interval (CI) 2.19-6.01), interactions with healthcare professionals (AOR 1.77, 95% CI 1.03-3.02), and degree of control over their hospital care (AOR 1.90, 95% CI 1.15-3.12) were more likely to have a high-level of involvement in SDM on antibiotic therapy.
Empowering hospitalized patients with involvement in decisions, interactions with healthcare professionals, and control of their hospital care can increase their participation in SDM on antibiotic therapy in hospitals.
一半的住院患者接受抗生素治疗，但他们很少参与抗生素治疗的共同决策（SDM）。我们试图了解患者赋权与他们参与抗生素治疗 SDM 的关联。
从 2021 年 3 月到 2022 年 4 月，我们在新加坡一家拥有 1600 张床位的成人综合医院对接受抗生素治疗至少 1 天的住院患者进行了一项横断面调查。问卷包括 SDM-Q-9 中的 7 个项目（5 分李克特量表）和 HCEQ-10 中的 10 个项目（4 分李克特量表），涉及患者参与 SDM 和患者赋权。构建多变量逻辑回归模型，以评估患者赋权的三个结构与抗生素治疗 SDM 之间的独立关联。
在 636 名住院患者中，平均年龄为 57.6（15.5）岁，61%为男性，37%具有高等教育水平。大多数（90%）患者知道自己正在接受抗生素治疗，但只有 11%的患者知道所给抗生素的名称。调整年龄、性别、种族、教育水平和住院时间后，参与决策程度较高的患者（调整后的优势比（AOR）3.63，95%置信区间（CI）2.19-6.01）、与医疗保健专业人员互动（AOR 1.77，95%CI 1.03-3.02）和对其医院护理的控制程度（AOR 1.90，95%CI 1.15-3.12）更有可能高度参与抗生素治疗的 SDM。
赋予住院患者参与决策、与医疗保健专业人员互动以及控制其医院护理的权力，可以提高他们在医院参与抗生素治疗 SDM 的程度。
