The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of U.S. Adults.
The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of U.S. Adults.
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DOI：
10.1080/10810730.2015.1033115
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发表时间：
2016
影响因子：
4.4
通讯作者：
Simon CJ
中科院分区：
文献类型：
--
作者：
Smith SG;Pandit A;Rush SR;Wolf MS;Simon CJ
研究调查偏好的共享决策（SDM）集中在协会与社会人口变量，很少有调查探索患者因素。我们的目的是调查在美国成年人的全国代表性横断面调查中，在6个常见的医疗决策中，患者激活和SDM偏好之间的关系。18岁以上的成年人在网上（n = 2，700）和电话（n = 700）招募。受访者完成了社会人口统计学评估和患者激活措施。他们还被问及是否认为SDM在6个常见的医疗决策中有好处（是/否）。近一半的样本（45.9%）达到最高激活水平（4级）。激活与年龄（p <0.001），高收入（p = 0.001），高等教育（p = 0.010），更好的自评健康（p <0.001）和更少的慢性病（p = 0.050）有关。同意SDM有益的人的比例从53.1%（决定诊断测试的必要性）到71.8%（与改变生活方式相关的决定）不等。在我们控制了参与者的特征之后，在6个决定中的4个决定中，较高的激活与SDM中更大的感知益处相关。SDM的偏好在6种常见的医疗场景中各不相同。低患者激活是SDM的一个重要障碍，可以通过开发行为干预来改善。
Studies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p < .001), higher income (p = .001), higher education (p = .010), better self-rated health (p < .001), and fewer chronic conditions (p = .050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.