Meng Xiangxu, Hong Chengang, Zhang Xingwei
School of Nursing, Hangzhou Normal University, Hangzhou 311121, China.
Healthcare (Basel). 2024 Sep 20;12(18):1883. doi: 10.3390/healthcare12181883.
The "paternalistic decision-making model" is no longer well suited to the modern clinical environment, and therefore, shared decision making (SDM) has emerged as a key approach. Although the benefits of SDM have been largely reported, several studies have reported low participation in SDM in coronary artery disease (CAD) patients. The theory of planned behavior (TPB) model is one of the most frequently employed theoretical frameworks for predicting human behaviors. According to the TPB, intention is influenced by attitude, subjective norm, and perceived behavioral control, while behavior is influenced by both intention and perceived behavioral control. Therefore, we propose a mixed methods study based on TPB to investigate the status of Chinese stable coronary artery disease (SCAD) patients' participation in SDM, understand their experiences of SDM, and explore the factors that influence their participation in SDM.
An explanatory sequential mixed methods design will be used to explore the study aims, including a quantitative phase, a subsequent qualitative phase, and the final integration study. The quantitative study will use convenient sampling from the Affiliated Hospital of Hangzhou Normal University to conduct a cross-sectional survey (n ≥ 252). The qualitative study will be sampled using the maximum difference sampling method from the quantitative study results, and then the data will be collected through semi-structured interviews (n = 10-20). This study will use descriptive statistics and test hypotheses while considering a -value of <0.05, which will be considered statistically significant.
The study employs a mixed method approach with an explanatory sequential design, incorporating qualitative and quantitative methods to comprehensively understand the factors influencing SCAD patients' participation in SDM. Furthermore, these findings can inform the design of future intervention studies and provide healthcare providers with targeted information and communication to help SCAD patients make the most appropriate decisions. Study participants will be recruited using convenience sampling from just one single clinical setting, which may limit the findings' generalizability.
This study has been approved by the Ethical Committee of the School of Nursing, Hangzhou Normal University (Approval No.: 2024013). All the participants will sign an informed consent form before participating in the survey. The corresponding results and conclusions will be disseminated in journals and conferences after the completion of the study.
“家长式决策模式”已不再适用于现代临床环境，因此，共同决策（SDM）已成为一种关键方法。尽管SDM的益处已得到大量报道，但多项研究表明冠状动脉疾病（CAD）患者参与SDM的程度较低。计划行为理论（TPB）模型是预测人类行为最常用的理论框架之一。根据TPB，意向受态度、主观规范和感知行为控制的影响，而行为受意向和感知行为控制的共同影响。因此，我们提出一项基于TPB的混合方法研究，以调查中国稳定型冠状动脉疾病（SCAD）患者参与SDM的现状，了解他们的SDM体验，并探索影响他们参与SDM的因素。
将采用解释性序列混合方法设计来探索研究目标，包括一个定量阶段、随后的定性阶段以及最后的整合研究。定量研究将采用便利抽样法，从杭州师范大学附属医院选取样本进行横断面调查（n≥252）。定性研究将从定量研究结果中采用最大差异抽样法选取样本，然后通过半结构化访谈收集数据（n = 10 - 20）。本研究将使用描述性统计并检验假设，同时考虑p值<0.05，这将被视为具有统计学意义。
本研究采用混合方法，采用解释性序列设计，结合定性和定量方法，全面了解影响SCAD患者参与SDM的因素。此外，这些研究结果可为未来干预研究的设计提供参考，并为医疗服务提供者提供有针对性的信息和沟通方式，以帮助SCAD患者做出最合适的决策。研究参与者将仅从一个临床机构采用便利抽样法招募，这可能会限制研究结果的普遍性。
本研究已获得杭州师范大学护理学院伦理委员会批准（批准号：2024013）。所有参与者在参与调查前将签署知情同意书。研究完成后，相应的结果和结论将在期刊和会议上发表。
