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

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.

Keywords

• climacteric syndrome|decision making, shared|menopausal hormone therapy|postmenopausal hormone replacement therapy|surveys and questionnaires|root cause analysis