首页|医患共同决策在恶性肿瘤疾病中实施的影响因素模型构建

医患共同决策在恶性肿瘤疾病中实施的影响因素模型构建

Construction of influencing factors model of doctor-patient shared decision-making in malignant tumor disease

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为探索医患共同决策在恶性肿瘤疾病治疗中的应用现状及影响因素,构建影响因素的理论模型,采用半结构访谈法对江苏省某三甲医院的医生和患者进行深度访谈,基于扎根理论,通过Nvivo20.0软件对访谈文本进行三级编码,最终归纳梳理出47个概念、20个子范畴和9个主范畴.以"环境""患者""医生""决策"作为4个核心范畴,外部环境、医疗体系、患者参与意愿、患者个人特征、决策成本、决策伦理、决策信息、医生态度、医生能力为9个主范畴,共同构成了医患共同决策在恶性肿瘤疾病治疗中影响因素的理论模型.医患共同决策的落实受多重因素影响,政府需要通过法律法规,营造良好的信息环境,医患之间需要有效沟通,逐步弥合信息不对等带来的差距,提升医疗满意度.
To explore the current application status and influencing factors of doctor-patient shared decision-making in treating malignant tumor diseases,this study aimed to construct a theoretical model of these influencing factors.The semi-structured interview method was used to conduct in-depth interviews with doctors and patients in a sizable top-three hospital in Jiangsu Province.Based on the grounded theory,the interview text was coded at the three-level coding by Nvivo 20.0 software,resulting identifying,47 concepts,20 sub-categories,and 9 main categories summarized and sorted out.Four core categories identified with"environment""patient""doctor"and"decision",and nine external environment categories were healthcare system,patient participation willingness,personal characteristics,decision-making cost,decision-making ethics,decision-making information,and doctors'attitude ability.These factors form the theoretical model of influencing factors of doctor-patient shared decision-making in treating malignant tumor diseases.The implementation of doctor-patient shared decision-making is affected by multiple factors.The government needs to create favorable information environment through laws and regulations,and effectively communicate between doctors and patients to deeply understand the demands of both sides and therefore respect the rights and interests of patients,and gradually bridge the gap caused by information inequality to improve medical satisfaction.

grounded theorymalignant tumorshared decision makinginfluencing factor

陈章晓、陆方

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南京医科大学医政学院,江苏 南京 211166

扎根理论 恶性肿瘤 医患共同决策 影响因素

江苏省高等学校哲学社会科学优秀创新团队项目

2024

南京医科大学学报(社会科学版)
南京医科大学

南京医科大学学报(社会科学版)

CHSSCD
影响因子:0.938
ISSN:1671-0479
年,卷(期):2024.24(2)
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