Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model
Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model
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DOI：
10.1016/s0277-9536(99)00145-8
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发表时间：
1999-09-01
影响因子：
5.4
通讯作者：
Whelan, T
中科院分区：
文献类型：
--
作者：
Charles, C;Gafni, A;Whelan, T
在这篇论文中，我们重新审视了我们早先关于在医疗遭遇中不同决策方法的背景下的共享治疗决策的概念框架并添加了元素(Charles，C.，Gafni，A.，Whelan，T.，1997)。医疗会诊中的共享决策：这意味着什么？(或者，至少需要两个人才能跳探戈)。Social Science BR Medicine 44,681-692.)，这个修订的框架(1)明确地确定了治疗决策过程中的不同分析步骤；(2)通过认识到在医疗会诊开始时采用的方法可能会随着交互作用的发展而改变，从而提供了治疗决策的动态视图；(3)确定了介于三种主要模式(家长式、共享式和信息式)之间的决策方法；(4)在临床实践、研究和医学教育中具有实际应用。我们不是提倡一种特定的方法，而是强调医生在构建决策过程的方式上的灵活性的重要性，以便尊重患者偏好的个体差异。(C)1999爱思唯尔科学有限公司。保留所有权利。
In this paper we revisit and add elements to our earlier conceptual framework on shared treatment decisionmaking within the context of different decision-making approaches in the medical encounter (Charles, C., Gafni, A., Whelan, T., 1997. Shared decision-making in the medical encounter: what does it mean? (or, it takes at least two to tango). Social Science Br Medicine 44, 681-692.), This revised framework (1) explicitly identifies different analytic steps in the treatment decision-making process; (2) provides a dynamic view of treatment decision-making by recognizing that the approach adopted at the outset of a medical encounter may change as the interaction evolves; (3) identifies decision-making approaches which lie between the three predominant models (paternalistic, shared and informed) and (4) has practical applications for clinical practice, research and medical education. Rather than advocating a particular approach, we emphasize the importance of flexibility in the way that physicians structure the decision-making process so that individual differences in patient preferences can be respected. (C) 1999 Elsevier Science Ltd. All rights reserved.