Say Rebecca, Murtagh Madeleine, Thomson Richard
School of Population and Health Sciences, Medical School, University of Newcastle, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
Patient Educ Couns. 2006 Feb;60(2):102-14. doi: 10.1016/j.pec.2005.02.003.
This review aimed to clarify present knowledge about the factors which influence patients' preference for involvement in medical decision making.
A thorough search of the literature was carried out to identify quantitative and qualitative studies investigating the factors which influence patients' preference for involvement in decision making. All studies were rigorously critically appraised.
Patients' preferences are influenced by: demographic variables (with younger, better educated patients and women being quite consistently found to prefer a more active role in decision making), their experience of illness and medical care, their diagnosis and health status, the type of decision they need to make, the amount of knowledge they have acquired about their condition, their attitude towards involvement, and the interactions and relationships they experience with health professionals. Their preferences are likely to develop over time as they gain experience and may change at different stages of their illness.
While patients' preferences for involvement in decision making are variable and the process of developing them likely to be highly complex, this review has identified a number of influences on patients' preference for involvement in medical decision making, some of which are consistent across studies.
By identifying the factors which might influence patients' preference for involvement, health professionals may be more sensitive to individual patients' preferences and provide better patient-centred care.
本综述旨在阐明目前关于影响患者参与医疗决策偏好的因素的知识。
对文献进行全面检索，以确定调查影响患者参与决策偏好因素的定量和定性研究。所有研究均经过严格的批判性评估。
患者的偏好受以下因素影响：人口统计学变量（研究一致发现，较年轻、受教育程度较高的患者以及女性更倾向于在决策中发挥更积极的作用）、他们的疾病和医疗护理经历、诊断和健康状况、他们需要做出的决策类型、他们对自身病情所掌握的知识量、他们对参与的态度，以及他们与医疗专业人员的互动和关系。随着经验的积累，他们的偏好可能会随时间发展，并且在疾病的不同阶段可能会发生变化。
虽然患者参与决策的偏好各不相同，且形成过程可能非常复杂，但本综述确定了一些对患者参与医疗决策偏好的影响因素，其中一些在各研究中是一致的。
通过确定可能影响患者参与偏好的因素，医疗专业人员可能会对个体患者的偏好更加敏感，并提供更好的以患者为中心的护理。
