'That's the doctor's job': Overcoming patient reluctance to be involved in medical decision making
'That's the doctor's job': Overcoming patient reluctance to be involved in medical decision making
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DOI：
10.1016/j.pec.2016.07.010
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发表时间：
2017-01-01
影响因子：
3.5
通讯作者：
Blumenthal-Barby, J. S.
中科院分区：
文献类型：
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作者：
Blumenthal-Barby, J. S.
目的：为了审查患者参与的障碍和技术，以增加患者参与他们的医疗决策和护理。讨论：障碍存在于他们的决策和护理的患者参与。个人障碍包括教育、语言和文化/态度（例如，尊重医生）。背景障碍包括时间（缺乏）和时机（例如，测试结果可用与患者就诊之间的滞后）。临床医生应该评估患者参与的兴趣以及他们对自己病情和选择的当前知识水平。以多种方式和模式构建信息可以增强理解，这可以使患者更加参与。决策辅助工具或对话录音等工具可以帮助患者记住重要信息，这是有意义的参与的要求。临床医生和研究人员应该努力建立社会规范，并围绕患者提出问题和表达他们的价值观进行提示。远程医疗和电子平台是很有前途的模式，让患者在一个非恐吓的氛围中提出问题。结论：研究人员和临床医生应该有动力找到方法来吸引患者的道德要求，许多患者更喜欢以某种方式参与，形状或形式;患者有更好的经验，当他们参与，参与改善健康结果。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Objective: To review the barriers to patient engagement and techniques to increase patients' engagement in their medical decision-making and care.Discussion: Barriers exist to patient involvement in their decision-making and care. Individual barriers include education, language, and culture/attitudes (e.g., deference to physicians). Contextual barriers include time (lack of) and timing (e.g., lag between test results being available and patient encounter). Clinicians should gauge patients' interest in being involved and their level of current knowledge about their condition and options. Framing information in multiple ways and modalities can enhance understanding, which can empower patients to become more engaged. Tools such as decision aids or audio recording of conversations can help patients remember important information, a requirement for meaningful engagement. Clinicians and researchers should work to create social norms and prompts around patients asking questions and expressing their values. Telehealth and electronic platforms are promising modalities for allowing patients to ask questions on in a non-intimidating atmosphere.Conclusion: Researchers and clinicians should be motivated to find ways to engage patients on the ethical imperative that many patients prefer to be more engaged in some way, shape, or form; patients have better experiences when they are engaged, and engagement improves health outcomes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.