Objective To understand the current situation of shared decision-making (SDM) in patients in the recovery period of schizophrenia(SCZ), and analyze its influencing factors and action paths.

Methods A total of 160 patients with SCZ were investigated using the General Information Questionnaire, Shared Decision Questionnaire-9 (SDM-Q-9), Decision Self-Efficacy Scale (DSES), Perceived ocial Support Rating Scale (PSSS) and Social Impairment Scale (SDSS), and the data analysis was conducted, which included the descriptive statistics, single-factor analysis, correlation analysis and chain mediating effect analysis.

Results The SDM score of 160 patients was (55.08 ± 9.89) points, among which 51 cases (31.9%) had a low level, 97 cases (60.6%) had a medium level, and 12 cases (7.5%) had a high level. The SDM was positively correlated with PSSS and DSES (r = 0.791 and 0.668, P ＜ 0.01), and negatively correlated with SDSS (r = –0.721, P ＜ 0.01). The PSSS was positively correlated with DSES (r = 0.632, P ＜ 0.01), and negatively correlated with SDSS (r = –0.593, P ＜ 0.01). DSES was negatively correlated with SDSS (r = –0.558, P ＜ 0.01). PSSS, PrepDMS, DSES and SDSS might be the main influencing factors of SDM (P ＜ 0.05), collectively explaining 74.6% of the total variation. PSSS had a direct effect on SDM, with an effect value of 0.569 (95%CI: 0.436–0.703). Meanwhile, it could have an indirect effect on SDM through SDSS and DSES, with an effect value of 0.357 (95%CI: 0.253–0.458).

Conclusions The SDM level of patients in the recovery period of SCZ needs to be improved. PSSS can not only directly affect SDM, but also indirectly influence SDM through the chain mediating effect between SDSS and DSES. Clinically, by understanding and strengthening patients' perception of social support and improving their SDSS, the self-efficacy of decision-making can be enhanced, and ultimately the SDM ability of patients can be improved.