Current Status Of Decisional Conflict Of Families Of Patients With Intracranial Tumor And Its Influencing Factors

Objective:To investigate the current situation of decisional conflict among families of patients with intracranial tumor,analyze its influencing factors and mechanisms of action.So as to provide a theoretical basis for the development of decisional conflict interventions and promote the improvement of medical decision-making quality of patients’families.Methods:1.Using convenience sampling method,patients with intracranial tumor and their families who met the inclusion criteria in three tertiary care hospitals in Urumqi were selected for the study from September2021 to February 2022.2.The general information questionnaire,disease information questionnaire,decisional conflict scale,appreciative social support scale,simple coping style scale and self-efficacy scale were carried out for the survey.3.SPSS 26.0 software was used for statistical analysis.The mean±standard deviation(X±S),frequency(n)and composition ratio(%)were used for descriptive analysis.X~2test and rank sum test were used to analyze the homogeneity of the basic information of the survey respondents in the three hospitals.Independent samples t-test,one-way ANOVA and pearson’s correlation analysis were used for one-way analysis,and then variables with statistically significant differences were included in multiple linear regression equations to analyze the factors influencing decisional conflicts among patients’families.AMOS24.0 software was used used for mediating effects analysis,the Bootstrap method was used to repeat randomly sampled data 5,000 times to test the mechanism of influencing factors on decisional conflict.The test level is a two-sided testα=0.05.Results:1.A total of 257 valid questionnaires were obtained for this study.Among the patients with intracranial tumor,141 were male and 116 were female;among the patients’families,122 were male and135 were female.The basic information of survey respondents in the three hospitals were homogeneous.2.The patients’families had a total score of(35.87±14.65)for decisional conflict,(57.67±11.95)for social support,and(25.12±6.83)for self-efficacy,all at a moderate level.On the brief coping style scale,the active coping dimension score was(29.95±4.85)and the negative coping dimension score was(8.16±1.77).3.Univariate analysis showed that patient’s tumor type,self-care ability,willingness to make decision and families’gender,place of residence,financial stress,and frequency of discussion between families and healthcare professionals about patients’conditions had an effect on families’decisional conflict scores(P<0.05).Pearson’s correlation analysis showed that decisional conflict in families of patients was negatively correlated with social support,self-efficacy,and active coping(P<0.05),but not with negative coping(P>0.05).4.Multiple linear regression analysis showed that patients’tumor type,willingness to make decision,and frequency of discussion between families and healthcare professionals about patients’conditions,social support,self-efficacy,and active coping had an effect on decisional conflict scores(P<0.05),which could jointly explain 55.5%of the total variance.5.Mediating effect results showed that self-efficacy and active coping partially mediated the effect between social support and decisional conflict.Social support could directly influence decisional conflict with an effect value of-0.257(P<0.05);it could also indirectly influence decisional conflict through self-efficacy and active coping with effect values of-0.123 and-0.153,respectively(P<0.05).The mediating effect accounted for 51.8%of the total effect.Conclusion:Families of patients with intracranial tumor had a moderate level of decisional conflict,and the quality of medical decision-making needs to be improved.Patients’tumor type,decision willingness and frequency of discussion between families and healthcare professionals about patients’conditions,social support,self-efficacy,and active coping were the influencing factors of decisional conflict among patients’families.In addition,self-efficacy and active coping as mediating variable between social support and decisional conflict,and healthcare professionals should improve the level of decisional confidence and active coping of patients’families with the help of personalized and targeted medical decision aids,so as to enhance the ameliorating effect of social support on decisional conflict.