Exploring Patient Involvement in Treatment Decision-Making for Diabetic Retinopathy: A COM-B Model-Based Cross-Sectional Survey

Ling Xu,1,2 Haili Zhang,1,2 Yan Shen,2 JingYan Pu,3 Qing Wu,1 Lan Chen2 1School of Nursing, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Intensive Care Unit, Jiangqiao Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Lan Chen, Department of Nursing, Shanghai General Hospital, Shanghai, People’s Republic of China, 200080, Email 18001890326@126.com Qing Wu, School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China, Email wendy925sh@163.comBackground:  Patient involvement in treatment decision-making has increasingly been emphasized in the healthcare system. However, research on patient involvement in treatment decision-making for diabetic retinopathy (DR) remains scarce in China. Guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model, this study aimed to explore the current status and influencing factors of patient involvement in treatment decision-making for DR.Methods:  This cross-sectional study recruited 336 patients with DR by convenience sampling from a tertiary hospital in Shanghai, China. The All Aspects of Health Literacy Scale (AAHLS), Social Support Rating Scale (SSRS), Facilitation of Patient Involvement Scale (FPIS), Decision Self-Efficacy Scale (DSES), and Patient Expectation for Participation in Medical Decision-making Scale (PEPMDS) were used to evaluate health literacy, social support, ophthalmologist facilitation of patient involvement, decision self-efficacy, and need for decision-making involvement, respectively. The Control Preference Scale (CPS) was used to assess patients’ actual involvement roles in treatment decision-making. Descriptive statistics, univariate, and unordered multinomial logistic regression analyses were conducted.Results: Among the 336 patients with DR, 21.1% reported an active role, 30.7% a collaborative role, and 48.2% a passive ...