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全科医疗中的共同决策:呼吸道感染患者真的需要它吗?

Shared-decision making in general practice: do patients with respiratory tract infections actually want it?

作者信息

Briel Matthias, Young Jim, Tschudi Peter, Hugenschmidt Christa, Bucher Heiner C, Langewitz Wolf

机构信息

Basel Institute for Clinical Epidemiology, University Hospital Basel, Switzerland.

出版信息

Swiss Med Wkly. 2007 Aug 25;137(33-34):483-5. doi: 10.4414/smw.2007.11891.

Abstract

BACKGROUND

There is conflicting evidence on whether patients wish to be involved in medical decisions.

METHODS

We interviewed 636 ambulatory patients with acute respiratory tract infections in cantons Basel-Stadt and Aargau. We asked whether they agreed with two statements that are the antithesis of shared-decision making. We used proportional odds regression to investigate how agreement with these two statements is associated with patient characteristics and with patient satisfaction and enablement.

RESULTS

Many patients (66%) supported leaving decision making to their physician. These patients were more likely to be satisfied with the consultation and scored higher on enablement. Patients whose responses were consistent with a preference for shared-decision making were more likely to be younger, better educated and in more discomfort.

CONCLUSION

Patients consulting a general practitioner for acute respiratory tract infections should be invited to participate in decision making although many may choose to decline.

摘要

背景

关于患者是否希望参与医疗决策,证据存在冲突。

方法

我们采访了巴塞尔城市半州和阿尔高州的636名急性呼吸道感染门诊患者。我们询问他们是否同意与共同决策相反的两种说法。我们使用比例优势回归来研究对这两种说法的认同如何与患者特征、患者满意度及赋能相关。

结果

许多患者(66%)支持将决策权留给医生。这些患者对咨询更满意,在赋能方面得分更高。其回答与共同决策偏好一致的患者更可能年龄较小、受教育程度较高且不适程度更高。

结论

尽管许多因急性呼吸道感染咨询全科医生的患者可能会选择拒绝,但仍应邀请他们参与决策。

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