Objective To investigate the current status and influencing factors of decision conflict regarding disease-modifying therapy in patients with spinal muscular atrophy (SMA), aiming to provide references for future interventions to improve the quality of patient decision-making. Methods Using convenience sampling, SMA patients admitted to the Department of Neurology, West China Hospital of Sichuan University between January 2023 and October 2025 were selected as study participants. Data were collected through questionnaires assessing general demographic characteristics, the Control Preferences Scale, and the Decisional Conflict Scale (DCS). Univariate analysis and multiple linear regression were employed to explore factors influencing patients’ decisional conflict. Results A total of 70 questionnaires were distributed, with 66 valid responses returned, resulting in an effective response rate of 94.3%. The standardized DCS score of SMA patients was 35.61±21.28, indicating moderate decisional conflict. Multiple linear regression analysis revealed that age [unstandardized partial regression coefficient (b)=?0.818, 95% confidence interval (?1.383, ?0.252), P=0.005] and residential location [b=?12.660, 95% confidence interval (?19.822, ?5.498), P=0.001] were independent influencing factors for decisional conflict, collectively explaining 35.0% of the variance (adjusted R2=0.318). Conclusions SMA patients exhibit moderate levels of disease-modifying therapy-related decisional conflict, with younger age and rural residence associated with more pronounced conflict. Clinical practice should focus on individual patient characteristics while enhancing decision aids and informational support to help reduce decisional uncertainty.
Objective To investigate the impact of shared decision-making (SDM) intervention on treatment expectations, decisional conflict, and satisfaction in patients with lung cancer and mediastinal tumors, aiming to provide a basis for optimizing personalized diagnosis and treatment models for oncology patients. MethodsPatients with lung cancer and mediastinal tumors who met the inclusion criteria, admitted by a single medical team in the Department of Thoracic Surgery, West China Hospital, Sichuan University, from November 2024 to May 2025, were randomly assigned to either a SDM group or a control group using a random number table method. The control group received conventional diagnostic and treatment interventions, while the SDM group received SDM-assisted interventions in addition to the conventional care. Baseline characteristics, treatment expectations, decisional conflict, and satisfaction were compared between the two groups. ResultsA total of 137 patients were included (69 patients in the SDM group, 68 patients in the control group). In the SDM group, there were 30 males and 39 females, with a mean age of (53.17±15.13) years. In the control group, there were 22 males and 46 females, with a mean age of (53.19±15.91) years. After intervention, the change score for treatment expectations in the SDM group was significantly lower than that in the control group [–9.0 (–9.0, –8.0) points vs. –2.0 (–3.0, –2.0) points, P<0.001]. The change score for decisional conflict in the SDM group was also significantly lower than that in the control group [–21.0 (–29.0, –12.0) points vs. –4.5 (–14.5, 1.0) points, P<0.001]. However, there was no statistically significant difference in satisfaction between the two groups [SDM group: 10.0 (10.0, 10.0) points vs. control group: 10.0 (10.0, 10.0) points, P=0.552]. ConclusionSDM intervention can effectively reduce the deviation in treatment expectations and decisional conflict in patients with lung cancer and mediastinal tumors. It holds important clinical value for enhancing patient engagement in care and optimizing personalized diagnosis and treatment processes.