Shared decision-making as a new quality indicator in nephrology: a nationwide survey in Germany
Shared decision-making as a new quality indicator in nephrology: a nationwide survey in Germany
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DOI：
10.1007/s00063-005-1021-5
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发表时间：
2005-04-15
影响因子：
--
通讯作者：
Pfaff, H
中科院分区：
文献类型：
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作者：
Scheibler, F;Stoffel, MP;Pfaff, H
共同决策作为肾病学新的质量指标：一项德国全国调查背景和目的：共同决策（SDM）作为医患互动的一种模式正在德国卫生系统中获得相关性。通过应用这一模型，预计中期和长期的改善，特别是在慢性病的结果。到目前为止，德国卫生服务研究中几乎没有关于SDM的现状和发展的实证数据。本研究建立了一个基线，并根据德国范围内终末期肾病（ESP，D）患者的调查提供了这一主题的实际数据。方法：在德国范围内对6614例ESRD患者进行标准化调查。问卷包括一个测量患者感知参与护理（PICS）的工具，该工具之前已被翻译和验证。结果：82%的受访患者认为他们的医生促进了他们参与决策。81%的患者主动告知自己的病情和治疗方案。69%的受访者表示已经实施了SDM。年龄、透析年数和性别与感知参与相关。结论：本研究为ESRD患者SDM的前瞻性研究提供了有效的基线，结果表明透析患者愿意参与医疗决策过程。患者的特点和偏好不仅应在日常临床互动中考虑。它们可以在质量管理的框架内系统地加以监测，并作为改进质量的潜力加以利用。
Shared Decision-Making as a New Quality Indicator in Nephrology: a Nationwide Survey in GermanyBackground and Purpose: Shared decision-making (SDM) as a model in physician-patient interaction is gaining relevance in the German health system. By applying this model, mid- and long-term improvements are expected especially in the outcomes of chronic diseases. Up to now, there has hardly been any empirical data available in German health services research regarding the state and development of SDM.This study establishes a baseline and provides actual data on this subject based on a German-wide survey of end-stage renal disease (ESP,D) patients.Methods: Standardized German-wide survey of 6,614 patients with ESRD. The questionnaire included an instrument to measure the patients' perceived involvement in care (PICS) which had been translated and validated before.Results: 82% of the questioned patients feel their physicians facilitated involvement in decision making. 81 % of the patients actively inform themselves concerning their disease and treatment options. 69% state that SDM has taken place. Age, years on dialysis and gender correlate with perceived involvement.Conclusion: This paper provides a valid baseline for the prospective research of SDM in ESRD The results indicate that dialysis patients are willing to participate in the process of medical decision-making. Characteristics and preferences of the patients should be taken into account not only in everyday clinical interactions. They could be monitored systematically within the framework of quality management and used as potential for quality improvement.