JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Patient Educ Couns. 2024 Dec;129:108410. doi: 10.1016/j.pec.2024.108410. Epub 2024 Aug 28.
This study aimed to investigate how doctor-patient communication, trust in doctors impacted patients' experience and satisfaction in shared decision-making (SDM).
This study is based on the data from a cross-sectional survey (n = 12,401) conducted in 27 public specialist outpatient clinics in Hong Kong.
The multivariable regression models revealed that doctors' better communication skills were associated with lower decision-making involvement (odd ratio, 0.75 [95 % CI, 0.88-0.94], P < .001) but higher satisfaction with involvement (odd ratio, 6.88 [95 % CI, 5.99-7.93], P < .001). Similarly, longer consultation durations were associated with reduced involvement in decision-making (odd ratio, 0.71 [95 % CI, 0.66-0.73], P < .001) but increased satisfaction with involvement (odd ratio, 1.91 [95 % CI, 1.80-2.04], P < .001). Trust in doctors significantly mediated these associations, except for the association between consultation duration and patients' satisfaction with decision-making involvement.
Doctors' better communication skills and longer consultations might not necessarily increase patient involvement in SDM but correlated with increased satisfaction with involvement. Trust in doctors emerged as a mediator for participation and satisfaction in decision-making.
Clinics should consider patients' preferences and capabilities when tailoring communication strategies about decision-making and optimizing patient satisfaction.
本研究旨在探讨医患沟通和对医生的信任如何影响患者在共同决策中的体验和满意度。
本研究基于在香港 27 家公立专科门诊进行的横断面调查（n=12401）的数据。
多变量回归模型显示，医生更好的沟通技巧与较低的决策参与度相关（比值比，0.75[95%置信区间，0.88-0.94]，P<0.001），但参与度满意度较高（比值比，6.88[95%置信区间，5.99-7.93]，P<0.001）。同样，较长的咨询时间与决策参与度降低相关（比值比，0.71[95%置信区间，0.66-0.73]，P<0.001），但参与度满意度增加（比值比，1.91[95%置信区间，1.80-2.04]，P<0.001）。除了咨询时间与患者对决策参与满意度之间的关联外，对医生的信任显著调节了这些关联。
医生更好的沟通技巧和更长的咨询时间不一定会增加患者在共同决策中的参与度，但与参与度的增加相关。对医生的信任是参与和决策满意度的一个中介因素。
诊所应在制定关于决策的沟通策略和优化患者满意度时考虑患者的偏好和能力。
