A Qualitative Study On The Attitudes And Influencing Factors Of Both Doctors And Patients To The Mode Of Shared Decision Making

BackgroundIn recent years,with the improvement of the health awareness of patients in China,the demand for participation in clinical decision-making is increasing.As a new medical decision-making model,shared decision making is to encourage clinicians to let patients participate in the discussion of diagnosis,treatment and follow-up,and to make the most suitable individual clinical decisions.This model is of great significance in improving the current tense doctor-patient relationship,promoting medical equality and enhancing patients’ treatment compliance.Research on shared decision making model in different disease fields is increasing.Infertility as a global public health problem,due to its open treatment characteristics,through the implementation of the shared decision making model can realize its personalized diagnosis and treatment plan decision to maximize the needs of patients in many aspects.At present,there is a lack of research on shared decision making in the treatment of infertile women in China,which affects the promotion and application of shared decision making in fertility treatment for infertile women.This study is to pass from infertility patients,patients’ family members,engaged in infertility diagnosis and treatment of a doctor the perspective of three different identity,to explore the infertility in the attitudes of different perspective on the doctor-patient decisions together and cause patient decision-making difficult factors to push together,and put forward constructive suggestions,to promote the application and development of shared decision making model.ObjectiveThe main objective of this article is to Shandong province sterility women and their spouses,engaged in infertility treatment doctors qualitative investigation,understand the tripartite perspective of doctor-patient attitudes and the reasons of the common decision model,and hinder the doctor-patient decisions together in infertility treatment process factors that influence the implementation of and discusses the solution to existing problems,in order to further the shared decision making model in the clinical application to provide certain reference basis.MethodsThis research adopts the purpose sampling method to determine the research object,using qualitative research method in November 2020-January 2021 a reproductive hospital in Jinan of Shandong province identified 19 women infertility patients,10 patients’ families,5 medical personnel engaged in the work of infertility treatment,using interview outline on the semi-structured in-depth interviews and focus group interviews.ResultsIn this study,a total of 19 infertile female patients,10 patients’ family members and 5 medical personnel were interviewed,and the results were summarized from two aspects:the respondents’ attitudes and reasons towards the shared decision making model,and the influencing factors that hinder the implementation of shared decision making were explored.(1)In the tripartite research on shared decision making,patients’ attitudes include supporting shared decision making and prefering doctor-led decision making.Among them,the reasons for patients to support shared decision making include better understanding of the treatment plan,relieving psychological pressure and improving their compliance;Reasons for wanting doctors to take the lead in making decisions include a belief that doctors have a lot of expertise and that patients don’t want to make decisions.The attitude of all patients’ partners and doctors is to support shared decision making.The reasons include strengthening doctor-patient communication,improving patient satisfaction,improving patient treatment compliance,and enhancing the sense of patient partner participation.(2)The influencing factors of shared decision making include:communication,psychological pressure,program preference and treatment process mentioned from the patient’s perspective;Partner participation in decision making from the patient partner perspective;From the perspective of doctors,communication,patient partner,trust,patient subjectivity and other four aspects are mentioned.Conclusion and suggestionsThis study found that 15 infertility patients,all of their partners and doctors supported the shared decision making model,and were willing to use this model to make decisions on fertility treatment programs.At present,from the perspective of patients,the influencing factors that hinder the application of shared decision making in infertility treatment include communication,psychological pressure,program preference and treatment process.From the perspective of the patient,the influencing factors include family members’ participation in decision-making;The influencing factors in the perspective of doctors include communication,patients’ family members,trust,and patients’ subjectivity.Suggestions(1)The joint force,strengthen the doctor-patient communication(2)The use of all kinds of psychological measurement tools,pay attention to patients psychological pressure(3)Encourage patient cooperate with each other,in-depth analysis of party preference(4)The optimization of treatment process,to ensure continuity(5)To protect patients’ privacy,encourage families with party to participate in decision-making(6)Using the network platform,a bridge to build trust.