中国全科医学 ›› 2023, Vol. 26 ›› Issue (33): 4181-4186.DOI: 10.12114/j.issn.1007-9572.2023.0219

• 论著 • 上一篇    下一篇

更年期综合征患者绝经激素治疗中医患共同决策质量的影响因素研究

周俞余1, 高川2, 崔埔安1, 王亚平3,*(), 何仲1,*()   

  1. 1.100730 北京市,北京协和医学院马克思主义学院 人文和社会科学学院
    2.100037 北京市,中国医学科学院阜外医院护理部
    3.100730 北京市,北京协和医院妇科内分泌与生殖中心
  • 收稿日期:2023-04-17 修回日期:2023-06-07 出版日期:2023-11-20 发布日期:2023-06-09
  • 通讯作者: 王亚平, 何仲

  • 作者贡献:周俞余提出主要研究目标,负责研究的构思与设计,研究的实施,撰写论文;高川、崔埔安进行论文修订;王亚平负责指导数据的收集整理及处理;何仲负责文章的质量控制与审查,对文章整体负责,监督管理。
  • 基金资助:
    教育部首批新文科研究与改革实践项目(2022-CFT-QT-057); 北京协和医学院中央高校基本科研项目(3332022163)

Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome

ZHOU Yuyu1, GAO Chuan2, CUI Puan1, WANG Yaping3,*(), HE Zhong1,*()   

  1. 1. School of Marxism/School of Humanities and Social Sciences, Peking Union Medical College, Beijing 100730, China
    2. Department of Nursing, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
    3. Center for Gynecological Endocrinology and Reproduction, Peking Union Medical College Hospital, Beijing 100730, China
  • Received:2023-04-17 Revised:2023-06-07 Published:2023-11-20 Online:2023-06-09
  • Contact: WANG Yaping, HE Zhong

摘要: 背景 绝经激素治疗(MHT)可以有效缓解更年期症状,但其治疗方案多种多样,做出符合女性需求的治疗决策至关重要,但目前对MHT中的医患共同决策(SDM)质量的调查有待补充。 目的 分析更年期综合征患者MHT中的SDM质量并探讨其影响因素,为实现对更年期群体更优质的临床照护提供理论依据。 方法 采用便利抽样法,于2022年10月—2023年1月抽取北京协和医院妇科内分泌与生殖中心的更年期综合征患者101例为研究对象。使用问卷调查法进行研究,问卷内容包括三部分,分别为一般人口资料、治疗相关信息及SDM质量调查。采用中文版共同决策问卷患者版(SDM-Q-9)评估患者的SDM质量。采用多元线性回归分析探讨更年期综合征患者MHT中SDM质量的影响因素。 结果 更年期综合征患者MHT中SDM质量的平均分为89.75分。有子女,MHT效果主观感受非常好,有潮热多汗、失眠、情绪波动症状,医生建议使用MHT的患者SDM质量得分更高(P<0.05)。多元线性回归分析结果显示,有子女(β=0.26,P=0.005)、潮热多汗(β=0.19,P=0.044)、失眠(β=0.23,P=0.017)、医生建议使用(β=0.21,P=0.025)是更年期综合征患者MHT中SDM质量的影响因素,可解释SDM质量23.7%的变异。 结论 更年期综合征患者MHT中SDM质量较好,有子女、潮热多汗、失眠、医生建议使用是更年期综合征患者MHT中SDM质量的影响因素,医生应更主动将患者纳入SDM中,使患者意识到自己是第一健康负责人,与医生共同做出符合患者需求与价值观的SDM。

关键词: 更年期综合征, 共同决策, 绝经激素治疗, 绝经后激素补充疗法, 调查和问卷, 影响因素分析

Abstract:

Background

Menopausal hormone therapy (MHT) can effectively relieve menopausal symptoms, but its treatment options are diverse, and it is essential to make treatment decisions meeting women's needs. However, the current investigation on the quality of shared decision making between doctors and patients (SDM) in menopausal hormone therapy needs to be supplemented.

Objective

To analyze the quality of SDM in MHT among menopausal syndrome patients and explore its influencing factors, so as to provide a theoretical basis for achieving quality clinical care for menopausal population.

Methods

A total of 101 patients with menopausal syndrome from Center for Gynecological Endocrinology and Reproduction in Peking Union Medical College Hospital from October 2022 to January 2023 were selected as study subjects. The study was conducted using the questionnaire method, which consisted of general demographic information, treatment-related information and SDM quality survey. The Chinese version of 9-items shared decision making questionnaire (SDM-Q-9) was used to assess the SDM quality of patients. Multiple linear regression analysis was used to explore the influencing factors of SDM quality in MHT among patients with menopausal syndrome. Multiple linear regression analysis was used to explore the influencing factors of the quality of SDM in MHT among patients with menopausal syndrome.

Results

The average score of SDM quality was 89.75. Patients with children, considered MHT to be very effective, with symptoms of hot flushes and sweating, insomnia and mood fluctuations, advised by doctors to receive MHT had better degree of participation in SDM (P<0.05). Multiple linear regression analysis showed that patients with children (β=0.26, P=0.005), hot flushes and sweating (β=0.19, P=0.044), insomnia (β=0.23, P=0.017) and recommendation by doctors (β=0.21, P=0.025) are influencing factors of SDM quality in MHT of patients with menopausal syndrome, which could explain 23.7% of the variation in SDM quality.

Conclusion

SDM quality is relatively good in MHT among menopausal syndrome patients. Patients with children, hot flashes and sweating, insomnia, and recommendation for use by doctors are influencing factors of SDM quality in MHT among menopausal syndrome patients. Doctors should take the initiative to include patients in SDM, so that patients can realize that they are the principal leader of their health and make SDM consistent with their needs and values in conjunction with doctors.

Key words: Climacteric syndrome, Decision making, shared, Menopausal hormone therapy, Postmenopausal hormone replacement therapy, Surveys and questionnaires, Root cause analysis