Cultural challenges to engaging patients in shared decision making.
Cultural challenges to engaging patients in shared decision making.
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DOI：
10.1016/j.pec.2016.07.008
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发表时间：
2017-01
影响因子：
3.5
通讯作者：
Morris AM
中科院分区：
文献类型：
--
作者：
Hawley ST;Morris AM
通过共同决策使患者参与医疗保健是几个国家和国际团体的优先事项。这些举措中缺少的是对让来自不同背景的患者参与共同决策所面临的挑战的理解。在这篇评论中，我们总结了一些挑战，并提出了关于如何走向更适合文化的共同决策的考虑点。在过去十年中，人们一再呼吁卫生政策、研究项目和干预措施更积极地将患者纳入决策。然而，研究表明，来自不同种族/民族和文化背景的患者对他们的决策过程的评价不如白色，美国，出生的病人是目前人口统计学上的大多数。虽然初步的概念框架已经提出了考虑种族/民族和文化在医疗保健利用的作用，我们认为，更多的基础和经验的工作是必要的。我们就如何最好地让患者尽早参与治疗以及如何以对患者最有意义的方式最大限度地做出决策提供建议。需要作出创新和持续的努力，教育和培训提供者进行有效沟通，让患者参与知情的共同决策，并提供文化上合格的保健服务。
Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care.
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