妇科恶性肿瘤患者手术决策冲突影响因素结构方程模型的构建OA

Objective To analyze the current situation and influencing factors of surgical decision-making conflicts in patients with gynecological malignant tumors with structural equation model constructed based on self-determination theory,and to lay a foundation for formulating plans to reduce decision-making conflicts and improve decision-making quality.Methods Convenience sampling was used to select 242 patients with gynecological malignant tumors who were treated in a tertiary grade-A specialized hospital in Urumqi,Xinjiang from October 2024 to March 2025.The General Information Questionnaire,Decision Conflict Scale,Decision Preparation scale,Chinese version of Comprehensive Health Literacy Scale,Decision Self-Efficacy Scale,Perceived Social Support Scale and Decision Expectation Scale were used to conduct the survey.AMOS4.0 software was used to construct a structural equation model.Results The score of surgical decision-making conflict in patients with gynecological malignant tumors was 31.25(26.56,39.06).The structural equation showed that perceived social support,decision-making self-efficacy,decision-making readiness,comprehensive health literacy,actual participation type and expected participation type were negatively correlated with decision-making conflict(P<0.05).Perceived social support,decision-making self-efficacy and decision-making readiness had a direct impact on decision-making conflict,and the direct effect values were-0.341,-0.313 and-0.271,respectively(P<0.05).Perceived social support,decision-making self-efficacy,comprehensive health literacy,expected participation type and actual participation type had indirect effects on decision-making con-flict,with indirect effect values of-0.292,-0.085,-0.105,-0.034 and-0.054,respectively(P<0.05).Conclusion Decision-making conflict of patients with gynecological tumor is at a moderate to high level.Perceived social support can directly and negatively predict decision-making conflict,and together with comprehensive health literacy,it affects decision-making conflict through multiple mediating effects of decision-making self-efficacy,decision-making expectation and decision-making readiness.