目的:通过自我决定理论的视角,这项定量研究调查了患者-提供者通过感知共享决策(SDM)和自主性的合作如何支持2型糖尿病(T2D)结局的影响.
方法:我们对474名18岁以上自我鉴定为T2D的个体进行了抽样。在一项在线调查中,来自两个独立小组的378名参与者收到了完整和有效的回复。使用IBM社会科学统计软件包(SPSS)分析数据,AMOS包,版本28和Mplus,版本8.8。
结果:患者-提供者通过自主支持合作提高了治疗满意度(β=.16,ρ<.05)和自我管理依从性(β=.43,ρ<.001)。虽然通过SDM的合作提高了治疗满意度(β=.25,ρ<.01),它恶化了SM粘附(β=-.31,ρ<.001)。我们的主持人减轻了SDM对自我管理依从性的负面影响,应对能力。然而,当提供自主支持时,应对能力对治疗满意度和SM依从性的影响最小。
结论:自主支持可提高治疗满意度和自我管理依从性。SDM可提高治疗满意度,但可能会对自我管理依从性产生不利影响。研究还表明,应对能力可以减轻SDM对自我管理依从性的负面影响,尽管当提供者提供自治支持时,其影响是有限的。
结论:对于提供者,SDM和自主性支持允许对治疗决策的共享权力,同时促进对自我管理任务的独立性。提供者应评估患者的应对能力,并根据患者的应对能力调整其护理方法。
OBJECTIVE: Through the lens of self-determination theory, this quantitative study investigates how patient-provider collaboration through perceived shared decision-making (SDM) and autonomy support impact type 2 diabetes (T2D) outcomes.
METHODS: We sampled 474 individuals over 18 years old who self-identified as having T2D. Completed and valid responses were received from 378 participants from two separate groups in an online survey. Data was analyzed using the IBM Statistical Package for Social Sciences (SPSS), AMOS package, version 28, and Mplus, version 8.8.
RESULTS: Patient-provider collaboration through autonomy support improved treatment satisfaction (β = .16, ρ < .05) and self-management adherence (β = .43, ρ < .001). While collaboration through SDM improved treatment satisfaction (β = .25, ρ < .01), it worsened SM adherence (β = -.31, ρ < .001). The negative impact of SDM on self-management adherence was mitigated by our moderator, coping ability. However, coping ability minimally impacted treatment satisfaction and SM adherence when autonomous support was provided.
CONCLUSIONS: Autonomy support increases treatment satisfaction and self-management adherence. SDM enhances treatment satisfaction but may adversely affect self-management adherence. The study also suggests that coping ability can mitigate the negative effect of SDM on self-management adherence, although its influence is limited when autonomy support is provided by the provider.
CONCLUSIONS: For providers, SDM and autonomy support permits shared power over treatment decisions while fostering independence over self-management tasks. Providers should evaluate patients\' coping ability and adapt their approach to care based on the patient\'s coping capacity.