Honorary Research Associate, Department of General Practice and Primary Care, Kings College London, London, UK.
Health Expect. 2010 Mar;13(1):45-54. doi: 10.1111/j.1369-7625.2009.00556.x. Epub 2009 Oct 7.
Decision aids (DAs) have been developed to help patients make treatment decisions. Research shows that they are effective in increasing patients' knowledge of treatment options without raising anxiety or conflict. However, they have not been routinely adopted for use in general practice in the UK and there are few reports addressing strategies to introduce them.
To examine patients' views about a variety of DAs for different conditions (heart disease, osteoporosis, osteoarthritis and breast cancer) in order to inform a strategy to introduce them into general practice.
General practice patients over the age of 18 years being or having been treated for one of the conditions above.
Qualitative study involving 12 focus groups with 77 patients evaluating decision aids relevant to their conditions. A semi-structured interview guide was used to generate discussions about the applicability of the DAs in routine general practice.
Patients welcomed DAs for their educational and informational content. Reactions to the DAs were influenced by patients' own personal desires for involvement. The main concerns were that the use of DAs would potentially shift the onus of decision making responsibility on to the patient and about the practical challenges to implementation.
Clinicians will need to make explicit to patients that DAs are an adjunct to routine care and not a replacement, and therefore do not represent a derogation of responsibility. DAs need to be used as an integral part of the communication and support process for patients who want them.
决策辅助工具（DAs）旨在帮助患者做出治疗决策。研究表明，它们在提高患者对治疗选择的了解方面非常有效，而不会增加焦虑或冲突。然而，它们并未在英国的常规实践中广泛采用，并且很少有报告探讨引入它们的策略。
调查患者对各种针对不同疾病（心脏病、骨质疏松症、骨关节炎和乳腺癌）的决策辅助工具的看法，以便为将其引入常规实践提供策略。
18 岁以上正在或曾经接受过上述条件之一治疗的普通科患者。
一项定性研究，包括 12 个焦点小组，共有 77 名患者参与，评估与他们的病情相关的决策辅助工具。使用半结构化访谈指南生成关于 DAs 在常规普通科实践中适用性的讨论。
患者欢迎 DAs 的教育和信息内容。对 DAs 的反应受到患者自身参与意愿的影响。主要关注点是，使用 DAs 可能会将决策责任转移到患者身上，以及实施的实际挑战。
临床医生需要向患者明确表示，DAs 是常规护理的辅助手段，而不是替代手段，因此并不代表责任的减损。对于希望使用 DAs 的患者，DAs 需要作为沟通和支持过程的一个组成部分来使用。
