Patients' preferences for involvement in the decision-making process for treating diabetic retinopathy.
Patients' preferences for involvement in the decision-making process for treating diabetic retinopathy.
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DOI：
10.1186/s12886-017-0526-z
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发表时间：
2017-08-09
影响因子：
2
通讯作者：
Roeck D
中科院分区：
文献类型：
--
作者：
Marahrens L;Kern R;Ziemssen T;Fritsche A;Martus P;Ziemssen F;Roeck D
评估与眼科主治医生在治疗糖尿病视网膜病变（DR）前的决策过程中的首选角色相关的因素。对810名参加二级糖尿病护理中心的成年人进行的横断面研究（NCT 02311504）。糖尿病患者采用眼科医生主导决策（ODM），共享决策（SDM）和患者主导决策（PDM）风格的有效问卷进行分类。进行多变量逻辑回归以确定与决策过程相关的因素。74.3%的患者倾向于医患间的SDM，17.4%的患者倾向于ODM，将决策过程委托给眼科医生，8.3%的患者倾向于PDM的自主式。需要ODM的患者年龄较大（OR = 1.2/10，p = 0.013），受教育程度较低（OR = 1.4，p = 0.001），每年就诊频率较高（OR = 1.3，p = 0.022）。DR基础知识和记忆HbA 1c水平较好的患者发生SDM的倾向较高（OR = 1.1，p = 0.037）。想要PDM的患者有显着较高的教育（OR = 1.3，p = 0.036）和更大的愿望，从自助团体（OR = 1.3，p = 0.015）接收信息。对DR治疗的一般患者愿望的首次评估证实了SDM的概念，该概念受到四分之三的青睐。特别是，受教育程度低的老年患者希望将决策过程委托给眼科医生。改善糖尿病项目中的眼科教育可能会增加患者的SDM倾向。无论决策小组如何，几乎所有的患者都希望眼科医生能够传递和分享医疗和科学信息。本研究于2014年12月4日在www.clinicaltrials.gov（标识符：NCT 02311504）上注册。本文的在线版本（doi：10.1186/s12886-017-0526-z）包含补充材料，可供授权用户使用。
To assess factors associated with the preferred role of the attending ophthalmologist in the decision-making processes before treating diabetic retinopathy (DR). Cross-sectional study of 810 adults attending secondary diabetes care centers (NCT02311504). Diabetes patients were classified using a validated questionnaire in an ophthalmologist-dominant decision-making (ODM), shared decision-making (SDM) and patient-dominant decision-making (PDM) style. Multivariate logistic regression was performed to determine factors associated with the decision-making process. A majority of 74.3% patients preferred SDM between ophthalmologist and patient, 17.4% patients wanted ODM, delegating the decision-making process to the ophthalmologist, 8.3% preferred the autonomous style of PDM. Patients wanting ODM were older (OR = 1.2 per decade, p = 0.013), had a lower level of education (OR = 1.4, p = 0.001) and had a higher frequency of consultations per year (OR = 1.3, p = 0.022). Patients with better basic knowledge in DR and memorizing their HbA1c level showed a higher propensity for SDM (OR = 1.1, p = 0.037). Patients wanting PDM had a significantly higher education (OR = 1.3, p = 0.036) and a greater desire for receiving information from self-help groups (OR = 1.3, p = 0.015). The first evaluation of the general patient wishes for the treatment of DR confirmed the concept of SDM, which was favored by three quarters. In particular, older patients with low educational attainment wanted to delegate the decision-making process to the ophthalmologist. Amelioration of ophthalmologic education in diabetic programs might take up patients’ propensity for SDM. Regardless of the decision-making group, nearly all patients wanted the medical and scientific information to be transferred by and shared with the ophthalmologist. The study was registered on www.clinicaltrials.gov (identifier: NCT02311504) on December 4th 2014. The online version of this article (doi:10.1186/s12886-017-0526-z) contains supplementary material, which is available to authorized users.
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影响因子：
3.2
作者：
Baars, Judith E.;Markus, Tineke;van der Woude, C. Janneke
通讯作者：
van der Woude, C. Janneke
影响因子：
7.2
作者：
DEGNER, LF;SLOAN, JA
通讯作者：
SLOAN, JA
影响因子：
8.1
作者：
Aiello, Lloyd Paul;Ayala, Allison R.;Wolpert, Howard A.
通讯作者：
Wolpert, Howard A.
影响因子：
5.4
作者：
Charles, C;Gafni, A;Whelan, T
通讯作者：
Whelan, T
DOI：
10.1016/j.ijsu.2006.01.005
发表时间：
2007-02-01
期刊：
International journal of surgery (London, England)
影响因子：
--
作者：
Kaba, R;Sooriakumaran, P
通讯作者：
Sooriakumaran, P