协和医学杂志

2019, v.10(06) 679-684

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患者偏好与医患共同决策
Patient Preference and Shared Decision Making

张渊;
ZHANG Yuan;Department of Health Research Methods,Evidence,and Impact,McMaster University;

摘要(Abstract):

循证医学提倡医务人员应用证据并考虑患者价值和偏好作出决策。医患共同决策基于医患双方均为"专家"的理念,即医生作为医学专家提供医学专业意见,而患者作为了解自身偏好的专家,双方在充分讨论后共同作出医学决策。在此过程中,医务人员应同时具备获取最佳证据以及应用决策辅助系统实现医患共同决策的能力。本文通过比较不同医学决策模式,讨论医患共同决策的理论与实践,并列举与中国医疗环境相关的、医患共同决策可能面临的挑战与障碍因素,以期为临床作出合理决策以及提高医疗服务质量提供借鉴。
Evidence-based medicine calls for consideration of the best available evidence and incorporation of patient values and preferences in health care decisions. The rationale of shared decision making is that both physicians and patients are experts,the physicians on medicine and the patients on their own preferences. Thus,it is essential for physicians and patients to exchange their expertise and make decisions together. To realize shared decision making in practice,physicians need to learn how to acquire the best available evidence,and how to use the decision aid to implement the shared decision making. This article compares different decision making approaches,and discusses the theory,practice,and the barriers to shared decision making specifically in China,aiming to support better clinical decision making and improvement of healthcare quality.

关键词(KeyWords): 患者偏好;医患共同决策;循证医学;决策辅助
patient preference;shared decision making;evidence-based medicine;decision aid

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作者(Author): 张渊;
ZHANG Yuan;Department of Health Research Methods,Evidence,and Impact,McMaster University;

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