ICU患者视角：后疫情时代医患关系与共同决策意愿的相关性分析

From the ICU Patient’s Perspective: A Correlation Analysis of the Doctor-Patient Relationship and Shared Decision-Making Willingness in the Post-Pandemic Era

摘要: 目的：探讨后疫情时代重症医学科(ICU)患者感知的医患关系现状、共同决策意愿水平及其二者之间的相关性，并分析共同决策意愿的关键影响因素。方法：于2022年12月至2023年2月，采用方便抽样法，对南部战区空军总院ICU的224名患者进行问卷调查。使用患者–医生关系问卷(PDRQ-9)和共同决策问卷患者版(SDM-Q-9)分别评估患者感知的医患关系与共同决策意愿。采用SPSS 22.0软件进行描述性统计分析、Pearson相关分析及多元线性回归分析。结果：患者的PDRQ-9得分为(22.84 ± 9.996)分，处于中等偏上水平；SDM-Q-9得分为(25.89 ± 9.532)分，处于中等水平。Pearson相关分析结果显示，医患关系与共同决策意愿之间存在显著的正相关性(r = 0.5059, P < 0.001)。多元线性回归分析进一步表明，医患关系(β = 0.3468, P < 0.001)及学历(β = 1.999, P = 0.0116)与共同决策意愿呈显著正相关，而年龄则与共同决策意愿呈显著负相关(β = −0.2898, P < 0.001)。结论：在后疫情时代，ICU患者感知的医患关系尚可，共同决策意愿有提升空间，且两者呈中度正相关。提示临床工作中通过加强有效沟通、改善医患关系并关注年轻及高学历患者的沟通需求，可作为促进共同决策实施、深化“以患者为中心”服务理念的有效途径。

Abstract: Objective: To investigate the current status of the Doctor-Patient Relationship (DPR) as perceived by patients, their level of Shared Decision-Making (SDM) willingness, the correlation between the two, and the key influencing factors of SDM willingness in the Intensive Care Unit (ICU) during the post-pandemic era. Methods: From December 2022 to February 2023, a convenience sample of 224 patients from the ICU of the Southern Theater Air Force General Hospital was surveyed using questionnaires. The Patient-Doctor Relationship Questionnaire (PDRQ-9) and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) were used to assess patients’ perception of the DPR and their willingness for SDM, respectively. Data were analyzed using descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis with SPSS 22.0. Results: The PDRQ-9 and SDM-Q-9 scores were (22.84 ± 9.996) and (25.89 ± 9.532), indicating a moderately good level of perceived DPR and a moderate level of SDM willingness, respectively. Pearson correlation analysis revealed a statistically significant positive correlation between DPR and SDM willingness (r = 0.5059, P < 0.001). Multiple linear regression analysis further indicated that the DPR (β = 0.3468, P < 0.001) and education level (β = 1.999, P = 0.0116) were significantly positively correlated with SDM willingness, while age showed a significantly negative correlation with SDM willingness (β = −0.2898, P < 0.001). Conclusion: In the post-pandemic era, ICU patients perceive a moderately good doctor-patient relationship, while their willingness for SDM remains at a moderate level with room for improvement, and a significant positive correlation exists between the two. This suggests that in clinical practice, enhancing effective communication, improving the doctor-patient relationship, and addressing the communication needs of younger and highly educated patients can serve as effective pathways to promote the implementation of SDM and deepen the patient-centered care model.