Decisional conflict is associated with quality of life and mental health in patients with inflammatory bowel disease

Abstract

Purpose Inflammatory bowel disease (IBD) patients are usually provided with multiple treatment options with different risks and benefits. This study aimed to assess the quality of decision-making in IBD patients concerning treatments, investigate the relationship between Shared decision-making (SDM) and decision conflict and health outcomes in patients with IBD, and explore the possible factors related to high decisional conflict in patients with IBD. Methods We conducted a cross-sectional, multicenter study. Patients were grouped according to their actual decision-making role and the level of decisional conflict. Propensity score analysis matched the two groups of patients 1:1 according to different factors. The main measures assessed included decisional conflict, decision regret, compliance, quality of physician communication, satisfaction, quality of life, anxiety, depression, and sleep disturbance. Multiple logistic regression was used to evaluate the factors affecting decisional conflict. Results Patients in the SDM group had a high awareness of the disease, and the impact of decision conflict and disease on work and learning was also low. The actual decision roles, physician communication quality, and disease activity may be independent factors affecting the decisional conflict. DCS was negatively correlated with the patient’s compliance and satisfaction with physician explanations and treatment and positively correlated with DRS, anxiety, depression, sleep disturbance, and SHS (all P <0.05). Conclusion: SDM is beneficial for improving the quality of decision making in patients with IBD. It is necessary to improve decisional conflict in IBD patients because it is closely related to patients' quality of life and mental health.