Analysis On The Status Of Shared Decision-making In Middle-aged And Elderly Patients With Type 2 Diabetes Mellitus At Tertiary Hospital In Changsha

Objective1.To understand the cognitive status of middle-aged and elderly T2DM patients in a tertiary hospital in Changsha about the subject of SDM and the degree of perceptual participation in the process of hospitalization.2.To analyze the influencing factors of SDM perceptual participation of middle-aged and elderly patients with T2DM in a tertiary hospital in Changsha.MethodsAdopt cross-sectional survey and use simple random sampling method.A questionnaire survey was conducted on 349 patients who met the inclusion criteria in four departments of geriatrics and endocrinology departments of a tertiary hospital in Changsha from June to November2020.The research tools included general data questionnaire and Perceived Involvement in Care Scale(PICS).SPSS26.0 was used for statistical analysis,measurement and counting data were described by mean plus and minus error(?),frequency and percentage respectively,univariate analysis,X~2 test for multivariate analysis,multi-classification Logistic regression analysis for multivariate analysis,the difference was statistically significant at P<0.05.Results1.The cognitive status of middle-aged and elderly patients with T2DM on the subject of SDM were as:doctors98.28%,nurses82.23%,myself77.36%,families 63.04%,pharmacists 48.14%,technicians 47.56%.As for the choice of the role of patients in SDM,the patients who were negative decision-makers 62.18%,followed by the common decision-makers31.81%,and the patients who chose active decision-makers 6.02%.As for the choice of treatment decision-making modes,0.57%of themself make decisions independently,21.78%of them choose medical staff make decisions independently,0.29%of them choose family members make decisions independently,17.48%of them choose themselves+medical staff make decisions together,1.71%of them choose themselves+family staff make decisions together,8.31%of them choose medical staff+family staff make decisions together.The proportion of myself+medical staff+family members make a joint decision accounted for 49.86%.2.The total score of PICS in middle-aged and elderly patients with T2DM was(7.75±2.49).Among them,low-level patients accounted for9.17%,middle-level patients accounted for 64.18%,and high-level patients accounted for 26.65%.The scores of the three dimensions were doctor’s encouragement to participate in decision-making(3.87±1.21),patient’s initiative to obtain information(2.61±1.09)and patient’s participation in decision-making(1.27±1.28).3.The results of multivariate analysis showed that there were significant differences in monthly income,long-term residence,course of disease,drinking alcohol or not,regular blood glucose monitoring,attention to disease,understanding of related information,number of related knowledge sources,the subject of SDM,the role of patients in SDM and the treatment decision-making modes(P<0.05).The results of ordered Logistic regression analysis showed that there were significant differences between drinking alcohol or not and the subjects of SDM(P<0.05).Conclusion1.Among the subject of SDM,the cognition of pharmacists and technicians is low level;in the role of patients in SDM,most patients are more likely to make negative decision-makers;the treatment decision-making modes,patients prefer to myself+medical staff+family members make a joint decision.2.The degree of SDM perceptual participation in middle-aged and elderly patients with T2DM is in the middle-level;drinking alcohol or not and the subject of SDM are the main influencing factors of SDM perceptual participation in middle-aged and elderly patients with T2DM.