Abstract: 【Abstract】Objective To understand the expectation, actual decision-making status and influencing factors of hemodialysis patient participating in vascular access. Methods Patients who chose or changed vascular access for the first time in Henan Provincial People's Hospital from November 2020 to July 2021 were selected as the subjects of the study. Their general information was investigated. The expected decision and actual decision of the patients were evaluated by Control Preference Scale (CPS). The consistency of expected decision and actual decision was analyzed. Univariate and binary logistic regression analyses were used to explore the influencing factors of decision making. Results A total of 202 questionnaires were sent out and 202 were received and valid, with the effective recovery rate of 100%. The consistency between expected decision and actual decision participation of the patients was 0.74. For expected decision- making, 75 cases (37.1%) had good sense and 127 cases (62.9%) had weak sense; for practical decision-making, 52 cases (25.7%) had good consciousness and 150 cases (74.3% ) had weak consciousness. Binary logistic regression analyses showed that age between 35 to 59 years (OR=28.179, 95% CI: 5.451～145.674, P<0.001), high school or technical secondary school education level (OR=0.026, 95% CI: 0.004～0.170, P<0.001), family monthly income>5000 RMB (OR=0.115, 95% CI: 0.032～0.409, P=0.004), and the number of vascular access selection
(OR=0.018, 95% CI: 0.002～0.141, P<0.001) were the influential factor for actual decision-making participation of the patients. Conclusion The expected decision participation of vascular access in hemodialysis patients is consistent with the actual decision-making type, and the low consciousness type is dominant in decision- making. To improve the situation of weak awareness of decision- making participation, medical staff should provide intervention programs based on the influencing factors and the decision-making needs of the patients.

Key words: Hemodialysis, Vascular access, Shared decision-making, Influencing factors