目的 探讨脑卒中患者康复期决策参与偏好的现状及其影响因素，为临床制订针对性干预措施提供依据。方法 2023年12月至2024年3月，采用便利抽样选取郑州市3所三级甲等医院神经内科收治的305例脑卒中患者为研究对象，采用一般资料调查量表、维克森林医师信任量表(Wick forest physician trust scale,WFPTS)、决策参与偏好评估量表(control preferences scale,CPS)、社会支持评定量表(social support rating scale,SSRS) 及全面健康素养测量量表(all aspects of health literacy scale,AAHLS) 对其进行调查。结果 脑卒中患者康复期决策参与偏好倾向于共享型的有156例(51.15%)、倾向于被动型的有104例(34.10%)、倾向于主动型的有45例(14.75%)。 Logistic回归分析显示，文化程度、对疾病了解程度、医疗支付形式、医生信任、社会支持及健康素养是脑卒中患者康复期决策参与偏好的主要影响因素(均P＜0.05)。结论 脑卒中患者康复期决策参与偏好存在异质性，医护人员应结合影响因素调整策略，助力患者主动参与决策，提高治愈率。

Objective To investigate the current status and influencing factors of decision-making participation preferences among stroke patients during rehabilitation,providing evidence for developing targeted clinical interventions.Methods From December 2023 to March 2024,305 stroke patients admitted to the Department of Neurology of three tertiary A hospitals in Zhengzhou City were selected by convenience sampling,and were investigated by using the General Information Questionnaire Scale,Wake Forest Physician Trust Scale (WFPTS),Control Preferences Scale (CPS),Social Support Rating Scale (SSRS),and All Aspects of Health Literacy Scale (AAHLS).Results Decision-making participation preferences of stroke patients during rehabilitation were as follows:156 cases (51.15%) preferred shared decision-making,104 cases (34.10%) preferred passive participation,and 45 cases (14.75%) preferred active participation.Logistic regression analysis showed that literacy,disease knowledge,form of medical payment,physician trust,social support,and health literacy were the main influences on decision-making participation preferences of stroke patients during rehabilitation(all P＜0.05).Conclusions Stroke patients exhibit heterogeneous decision-making participation preferences during rehabilitation.Healthcare professionals should adjust their strategies based on the influencing factors to facilitate patients’ active participation in decision-making and improve treatment outcomes.

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国家自然科学基金（72004205)；教育部重点实验室开放基金（LNYBPY-2023-01)；河南省科技攻关项目（252102310157)；河南省科技攻关项目(242102310295)