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· 200 · Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2024年4月
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影响因素模型分析［J］. 中国卫生事业管理，2021，38 （本文编辑：姜 鑫）

Construction of influencing factors model of doctor⁃patient shared

decision⁃making in malignant tumor disease
CHEN Zhangxiao，LU Fang
School of Health Policy and Management，Nanjing Medical University，Nanjing 211166，China
Abstract：To explore the current application status and influencing factors of doctor⁃patient shared decision⁃
making in treating malignant tumor diseases，this study aimed to construct a theoretical model of these
influencing factors. The semi⁃structured interview method was used to conduct in⁃depth interviews with doctors
and patients in a sizable top⁃three hospital in Jiangsu Province. Based on the grounded theory，the interview
text was coded at the three⁃level coding by Nvivo 20.0 software，resulting identifying，47 concepts，20 sub⁃
categories，and 9 main categories summarized and sorted out. Four core categories identified with“environment”
“patient”“doctor”and“decision”，and nine external environment categories were healthcare system，patient
participation willingness，personal characteristics，decision ⁃ making cost，decision ⁃ making ethics，decision ⁃
making information，and doctors’attitude ability. These factors form the theoretical model of influencing factors
of doctor⁃patient shared decision⁃making in treating malignant tumor diseases. The implementation of doctor⁃
patient shared decision ⁃ making is affected by multiple factors. The government needs to create favorable
information environment through laws and regulations， and effectively communicate between doctors and
patients to deeply understand the demands of both sides and therefore respect the rights and interests of
patients，and gradually bridge the gap caused by information inequality to improve medical satisfaction.
Key words：grounded theory；malignant tumor；shared decision making；influencing factor