Palliative Medicine and Decision Science: The Critical Need for a Shared Agenda To Foster Informed Patient Choice in Serious Illness
Palliative Medicine and Decision Science: The Critical Need for a Shared Agenda To Foster Informed Patient Choice in Serious Illness
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DOI：
10.1089/jpm.2011.0032
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发表时间：
2011-10-01
影响因子：
2.8
通讯作者：
Volandes, Angelo E.
中科院分区：
文献类型：
--
作者：
Bakitas, Marie;Kryworuchko, Jennifer;Volandes, Angelo E.
帮助患者及其家属做出复杂的决策是姑息治疗的一项基本技能；然而，姑息治疗的临床医生和科学家才刚刚开始为帮助患者和家属做出复杂决策的最佳实践建立一个证据基础。决策科学家的目标是理解和澄清共享决策(SDM)、决策支持和知情患者选择的概念和技术，以确保患者和家庭的观点塑造他们的医疗保健体验。重病患者及其家人在病程和死亡临近时面临着无数复杂的决定。如果患者丧失能力，那么代理决策者将扮演决策角色。姑息治疗和决策科学领域的发展是并行的。通过加强合作，推动严重疾病复杂决策的实践，将会有很大的收获。这篇文章的目的是用一个案例研究来强调一种限制生命的疾病带来的一系列困难的决定、问题和机会，以说明姑息治疗和决策科学研究人员、理论家和临床医生之间的合作和联合研究议程如何指导患者及其家人的最佳实践。
Assisting patients and their families in complex decision making is a foundational skill in palliative care; however, palliative care clinicians and scientists have just begun to establish an evidence base for best practice in assisting patients and families in complex decision making. Decision scientists aim to understand and clarify the concepts and techniques of shared decision making (SDM), decision support, and informed patient choice in order to ensure that patient and family perspectives shape their health care experience. Patients with serious illness and their families are faced with myriad complex decisions over the course of illness and as death approaches. If patients lose capacity, then surrogate decision makers are cast into the decision-making role. The fields of palliative care and decision science have grown in parallel. There is much to be gained in advancing the practices of complex decision making in serious illness through increased collaboration. The purpose of this article is to use a case study to highlight the broad range of difficult decisions, issues, and opportunities imposed by a life-limiting illness in order to illustrate how collaboration and a joint research agenda between palliative care and decision science researchers, theorists, and clinicians might guide best practices for patients and their families.