关键词: 多囊卵巢综合征, 共同决策, 病人参与, 影响因素分析

Abstract: Background　Shared decision-making has become a key initiative for healthcare development along with the advances in healthcare delivery models.Deep understanding of polycystic ovarian syndrome（PCOS）patients' attitude toward and real involvement in decision-making will help the patients to make more satisfactory clinical decisions.Objective　To explore PCOS patients' preferences for participation in shared decision-making and associated factors.Methods　PCOS patients were selected from the gynecological endocrinology center of Peking Union Medical College Hospital，and the reproductive gynecology department of the First People's Hospital of Yunnan from April to June 2020.An investigation was conducted to collect their demographic information，and preferences for participation and real involvement in shared decision-making using a self-developed demographic information questionnaire，and the Chinese version of Control Preferences Scale，respectively.Univariate and multivariate Logistic regression analyses were used to identify the influencing factors of patients' participation in decision-making.Results　A total of 240 cases attended the investigation，and 234（97.5%） of them（including 119 from Yunnan and 115 from Beijing） handed in responsive questionnaires were finally included.The rates of respondents preferring an active role，collaborative role，and passive role in shared decision-making were 5.1%（12/234），65.4%（153/234），and 29.5%（69/234），respectively.The rates of respondents actually playing an active role，collaborative role，and passive role in shared decision-making were 5.6%（13/234），36.3%（85/234），and 58.1%（136/234），respectively.The respondents from Beijing showed significant differences in their preferences for and real involvement in shared decision-making，so did those from Yunnan（P<0.01）.Multivariate Logistic regression analysis showed that education level〔OR=17.840，95%CI（6.175，51.539）〕，average monthly household income〔OR=3.074，95%CI（1.528，6.144）〕influenced PCOS patients' preferences for participation in shared decision-making（P<0.05）.Besides，education level〔OR=4.529，95%CI（2.468，8.311）〕，average monthly household income〔OR=1.461，95%CI（1.045，2.044）〕influenced PCOS patients' actual participation in shared decision-making（P<0.05）.Conclusion　Most PCOS patients preferred taking an active role in their shared decision-making，but showed a low rate of actually participating in shared decision-making.Higher education level and average monthly household income were associated with higher intention to participate in shared decision-making and higher rate of actually participating in shared decision-making.To make more satisfactory treatment decisions and reduce the possibility of having regrets in decision-making，both doctors and patients should correctly understand and use shared decision-making to achieve effective communication.

Key words: Polycystic ovary syndrome；Decision making, shared；Patient participation；Root cause analysis