DataSheet2_Applying Theory of Planned Behavior to Understand Physicians’ Shared Decision-Making With Patients With Acute Respiratory Infections in Primary Care: A Cross-Sectional Study.PDF

Background: To understand the physicians’ shared decision-making behavior (SDM) with patients with acute respiratory infections (ARIs) based on the theory of planned behavior (TPB) and identify barriers to the implementation of SDM in primary care.
Methods: A cross-sectional study of 617 primary care physicians was conducted in primary facilities in Hubei province, China from December 2019 to January 2020. A self-administered questionnaire based on TPB theory was applied for measuring the physicians’ SDM behavior with patients presenting with ARIs.
Results: The proposed TPB model revealed that attitude and subjective norms predicted behavior intention, and behavior intention was one significant predictor of SDM behavior (p < 0.001). After controlling for physicians’ demographic characteristics, receiving training regarding antibiotics was significantly associated with physicians’ attitudes toward SDM, while educational level and gender were significantly associated with physicians’ intention of engaging in SDM (p < 0.05). Physicians’ perceptions of patients’ expectations and incapability of making decisions were the most frequently reported barriers to the implementation of SDM.
Conclusion: The TPB theory provides insights for understanding physicians’ SDM behavior with patients with ARIs in primary care. Since attitudes, subjective norms, and behavior intention were demonstrated as significant predictors of SDM behavior, these may be a promising focus of SDM interventions based on TPB theory. The results of the TPB model and potential barriers of SDM behavior would help determine future directions for SDM training and educating the public.

研究背景：本研究基于计划行为理论（Theory of Planned Behavior, TPB），旨在探讨基层医疗中医师与急性呼吸道感染（Acute Respiratory Infections, ARIs）患者开展共同决策行为（Shared Decision-Making Behavior, SDM）的相关模式，并识别基层医疗场景下实施共同决策行为的阻碍因素。
研究方法：本研究于2019年12月至2020年1月在中国湖北省各级基层医疗机构开展，共纳入617名基层医疗医师参与横断面调查。研究采用基于计划行为理论编制的自填式问卷，评估医师与急性呼吸道感染患者开展共同决策行为的实际表现。
研究结果：本研究构建的计划行为理论模型显示，医师对共同决策的态度与主观规范可显著预测其行为意向，且行为意向是共同决策行为的重要预测因子（p < 0.001）。在控制医师人口统计学特征变量后，接受抗生素相关培训与医师对共同决策的态度呈显著相关；而受教育水平与性别则与医师参与共同决策的行为意向显著相关（p < 0.05）。医师感知到的患者期望以及患者缺乏决策能力，是报告频次最高的共同决策实施阻碍因素。
研究结论：计划行为理论可为理解基层医疗中医师与急性呼吸道感染患者的共同决策行为提供有效理论视角。鉴于态度、主观规范与行为意向均被证实为共同决策行为的重要预测因子，上述因素可作为基于计划行为理论的共同决策干预措施的重点优化方向。本研究的计划行为理论模型结果以及共同决策行为的潜在阻碍因素，可为未来共同决策培训项目与公众健康教育工作明确发展方向。