The Research Of Status And Associated Factors Of Patients With Type 2 Diabetes Mellitus Involved In Shared Decision-Making

Objective:The aim of this study is to find out the extent of shared decision making and actual participation of type 2 diabetic patients,to identify the differences in their socio-demographic and disease-related information,and to further reveal the influence of general demographic information,disease-related information,decision self-efficacy,social support level and treatment burden on the attitude and actual participation of type 2diabetic patients in shared decision making,to enrich the research on shared decision making of type 2 diabetic patients.This study will provide a theoretical reference for future intervention studies and contribute to the improvement of the awareness of health management and the comprehensive prevention and treatment mechanism for chronic diseases.Methods:The study was a cross-sectional survey study.274 patients with type 2 diabetes mellitus who were admitted to the endocrine department of a tertiary care hospital in Nanning between January 2022 and October 2022 were selected using the General Information Questionnaire for Patients with Type 2 Diabetes Mellitus,the Patient Participation in Treatment Decision Making Questionnaire,the Decision Making Self-Efficacy Scale,the The Social Support Rating Scale(SSRS)and Treatment Burden Questionnaire(TBQ)were used to conduct the questionnaire.SPSS 23.0 statistical software was used for data analysis,and the data were analysed as follows:(1)Count data were expressed as frequency(N),rate(%)and composition ratio(%),and measurement data were expressed as mean ± standard deviation or median(M)and quartiles(P25,P75).(2)Paired rank sum test was used for consistency analysis(3)Cardinality test and Spearman’s correlation analysis were used for one-way analysis and binary logistic regression analysis was applied for multi-way analysis.Results:(1)85.04% of patients with type 2 diabetes had a positive attitude towards shared decision making;60.9% of patients with type 2diabetes had a high level of actual participation in decision making.The actual level of patient involvement in shared decision-making was not consistent with a positive attitude,with a consistency test Kappa coefficient of0.327,and the numbers of type 2 diabetes patients with positive attitudes towards shared decision-making were higher than those with high levels of actual involvement in shared decision-making(p<0.05).(2)The results of univariate analysis of attitudes towards shared decision making showed that gender,age,education level,monthly per capita household income,number of children,health insurance payment method,duration of illness,number of hospitalizations for diabetes per year,decision self-efficacy,and level of social support had an effect on attitudes towards shared decision making(p<0.05).The results of binary logistic regression analysis showed that age,per capita monthly income,health insurance payment method,disease duration,number of hospitalizations for diabetes per year,decision self-efficacy,and social support were factors influencing the attitude of type 2 diabetes patients towards shared decision making(P<0.05),but the effect of treatment burden on patients’ attitude towards shared decision making was not statistically significant(P>0.05).(3)The results of the univariate analysis of actual participation in shared decision-making showed that gender,age,education level,number of children,per capita monthly household income,health insurance payment method,home address,duration of illness,knowledge of diabetes health,patients’ decision-making self-efficacy,level of social support,treatment burden,and attitude towards shared decision-making had an effect on actual participation in shared decision-making(p<0.05);binary Logistic regression analysis showed that age,duration of illness,knowledge of diabetes,number of hospitalizations due to diabetes per year,decision self-efficacy,social support,and attitude towards shared decision making were independent factors influencing the actual level of participation in shared decision making among patients with type 2 diabetes(P<0.05),and treatment burden had no significant effect on the level of participation in shared decision making among patients(P>0.05).Conclusion:(1)Patients with type 2 diabetes have a positive attitude towards shared decision making,however,the actual level of participation in shared decision making in clinical practice is not consistent with their positive attitude,with only half of the patients having a high level of participation in shared decision making,which needs to be further improved.(2)Age,monthly per capita household income,health insurance cost payment method,duration of illness,number of hospitalisations per year for diabetes,decision self-efficacy,and social support were factors influencing attitudes towards shared decision making participation among people with type 2 diabetes.(3)Age,duration of disease,knowledge of diabetes,number of hospitalisations per year for diabetes,self-efficacy in decision making,social support,and attitudes towards shared decision making participation were factors influencing the actual level of participation in shared decision making among people with type 2 diabetes.