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推进基层医疗中跨专业共同决策方法的理论、模型与测量:一项研究方案

Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol.

作者信息

Légaré France, Stacey Dawn, Graham Ian D, Elwyn Glyn, Pluye Pierre, Gagnon Marie-Pierre, Frosch Dominick, Harrison Margaret B, Kryworuchko Jennifer, Pouliot Sophie, Desroches Sophie

机构信息

Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada.

出版信息

BMC Health Serv Res. 2008 Jan 3;8:2. doi: 10.1186/1472-6963-8-2.

Abstract

BACKGROUND

Shared decision-making (SDM) is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare.

METHODS/DESIGN: An inventory of SDM conceptual models, theories and measurement tools will be created. Models will be critically assessed and compared according to their strengths, limitations, acknowledgement of interprofessional roles in the process of SDM and relevance to primary care. Based on the theory analysis, a conceptual model and a set of measurements tools that could be used to enhance an interprofessional approach to SDM in primary healthcare will be proposed and pilot-tested with key stakeholders and primary healthcare teams.

DISCUSSION

This study protocol is informative for researchers and clinicians interested in designing and/or conducting future studies and educating health professionals to improve how primary healthcare teams foster active participation of patients in making health decisions using a more coordinated approach.

摘要

背景

共同决策(SDM)被定义为医疗从业者与患者共同做出医疗选择的过程。尽管初级保健中的许多诊断和治疗过程涉及不止一种类型的卫生专业人员,但大多数共同决策概念模型和理论似乎仅限于医患二元组。本研究的目的是开发一个概念模型,并提出一套测量工具,以加强初级卫生保健中共同决策的跨专业方法。

方法/设计:将创建一份共同决策概念模型、理论和测量工具的清单。将根据模型的优势、局限性、在共同决策过程中对跨专业角色的认可程度以及与初级保健的相关性对模型进行严格评估和比较。基于理论分析,将提出一个概念模型和一套可用于加强初级卫生保健中共同决策跨专业方法的测量工具,并与关键利益相关者和初级卫生保健团队进行试点测试。

讨论

本研究方案对于有兴趣设计和/或开展未来研究以及教育卫生专业人员以改善初级卫生保健团队如何采用更协调的方法促进患者积极参与健康决策的研究人员和临床医生具有参考价值。

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