Shared Decision Making: Examining Key Elements And Barriers To Adoption Into Routine Clinical Practice
Shared Decision Making: Examining Key Elements And Barriers To Adoption Into Routine Clinical Practice
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DOI：
10.1377/hlthaff.2012.1078
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发表时间：
2013-02-01
期刊：
影响因子：
9.7
通讯作者：
Witteman, Holly O.
中科院分区：
文献类型：
--
作者：
Legare, France;Witteman, Holly O.
对许多患者来说，与他们的医生（临床医师）会面的时间是他们通过共同决策过程参与自己健康的最佳时机。在美国，共同决策正在得到推广，因为它有可能改善人口和个体患者的健康，同时也有助于控制医疗成本。在这篇综述中，我们描述了共同决策的三个基本要素：认识和承认需要做出决定;了解和理解现有的最佳证据;并将患者的价值观和偏好纳入决策。为了实现共同决策的承诺，更多的医生需要接受这种方法的培训，更多的实践需要围绕患者参与的原则进行重组。还需要进行更多的研究，以确定最有效的干预措施。
For many patients, the time spent meeting with their physician-the clinical encounter-is the most opportune moment for them to become engaged in their own health through the process of shared decision making. In the United States shared decision making is being promoted for its potential to improve the health of populations and individual patients, while also helping control care costs. In this overview we describe the three essential elements of shared decision making: recognizing and acknowledging that a decision is required; knowing and understanding the best available evidence; and incorporating the patient's values and preferences into the decision. To achieve the promise of shared decision making, more physicians need training in the approach, and more practices need to be reorganized around the principles of patient engagement. Additional research is also needed to identify the interventions that are most effective.