Survey and analysis of the shared decision-making concept and the influencing factors for depression in outpatient clinics of tertiary hospitals
10.3760/cma.j.cn113661-20231124-00227
- VernacularTitle:三级医院门诊抑郁症医患共同决策理念调查及影响因素分析
- Author:
Xilong CUI
1
;
Xiaoping WANG
;
Ning ZHANG
;
Jianlin JI
;
Xiufeng XU
;
Daihui PENG
;
Yuping NING
;
Jie LI
;
Guoqing JIANG
;
Ruiling ZHANG
;
Qiang WANG
;
Zheng LU
;
Cuixia AN
Author Information
1. 中南大学湘雅二医院，长沙 410011
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Shared decision-making;
Questionnaire survey;
Multi-center;
Tertiary hospital;
Psychiatric specialist hospital;
General hospital
- From:
Chinese Journal of Psychiatry
2024;57(12):819-827
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the current willingness of depressive outpatients and their doctors in China to engage in shared decision-making (SDM), and to analyze the factors influencing this willingness.Methods:A questionnaire survey was conducted among doctors and patients with depression in 12 tertiary psychiatric hospitals and general hospitals by scanning two-dimensional code and filling in the questionnaire on the mobile terminal. The questionnaire covered patient demographics, emotional state scores, initial diagnosis and treatment, treatment expectations and concerns, symptom improvement needs, medication safety requirements, and diagnosis details (completed by the attending physician). Doctors provided basic information, current depression diagnosis and treatment status, and concerns regarding medications. Logistic regression analysis (univariate and multivariate) was used to identify factors influencing patients′ and doctors′ willingness to engage in SDM.Results:A total of 622 valid patient questionnaires and 45 valid physician questionnaires were collected. Both patients and doctors had a strong willingness to make shared decisions (80.39% (500/622) vs. 60.00% (27/45)). Multivariate binary logistic regression analysis showed that residential location (town versus rural areas: OR (95% CI)=1.895 (1.087-3.305)), acceptable monthly medical expenses (≥1 000-<2 000 CNY vs.<300 CNY: OR (95% CI)=0.194 (0.088-0.427);≥2 000 CNY vs.<300 CNY: OR (95% CI)=0.267 (0.094-0.754)), acceptance of online treatment and consultation (accept versus not accept: OR (95% CI)=3.196 (2.024-5.046)), and knowing about psychotherapy (yes versus no: OR (95% CI)=1.711 (1.003-2.921)) were the factors influencing the willingness of shared decision-making in patients (all P<0.05). For the doctors, the time spent on initial consultation was the factor influencing the willingness to engage in SDM ( OR (95% CI)=1.090 (1.004-1.184), P=0.040). Conclusions:Both depression patients and doctors in tertiary outpatient clinics in China show a strong willingness to engage in SDM, providing a solid foundation for clinical application. However, it is necessary to pay attention to the influence of residential location, acceptable monthly medical expenses, acceptance of online treatment and consultation, and knowledge of psychotherapy should be considered for patients, while the time spent on initial consultations should be considered for doctors.
