协和医学杂志

2018, v.9(03) 277-280

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医患共同决策
Shared Decision Making

洪霞;
HONG Xia;Department of Psychological Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

在新的医学模式下,单纯以医生为主导已不能适应现代医疗环境下的医疗服务。医患共同决策(shared decision making,SDM)的内涵是医生运用专业知识,与患者在充分讨论治疗选择、获益与损伤等各种可能的情况下,并考虑到患者的价值观、倾向性及处境后,由医生与患者共同参与作出的、最适合患者个体的健康决策过程。本文就SDM的历史沿革、提倡SDM的原因、患者对SDM的需求与视角、如何在医疗实践中实施SDM进行阐述,启示临床医生一方面需具备现代医学知识与技能,如循证医学的方法以获得最佳临床证据;同时还需具备以患者为中心的沟通技能,与患者建立和谐、信任的医患关系,了解患者对治疗的偏好,在此基础上进行SDM,从而达到最佳医疗照护。
Over time,there have been major changes in the role of doctors and patients in decision-making.Shared Decision Making implies that doctors and patients make a decision jointly after communicating information about treatment options,benefits,and harms,and then considering the patient's values,circumstances and preference. Historical evolution,the reason why we need SDM,patients' perceptions of SDM,and how to implement SDM in clinical practice were introduced in this paper,which illuminated that medicine should be practiced with not only new evidence and techniques but also patient-centered communication skills. With shared decision-making,we can build a good doctor-patient relationship,be aware of patients' preference,and achieve optimal patient care.

关键词(KeyWords): 医患共同决策;循证医学;医学伦理学;医患沟通
shared decision making;evidence-based medicine;medical ethics;patient-centered communication skills

Abstract:

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基金项目(Foundation): 北京协和医学院教育教学改革项目(2014zlgc0119)

作者(Author): 洪霞;
HONG Xia;Department of Psychological Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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