Bhugra Dinesh, Malliaris Yanni, Gupta Susham
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
Australas Psychiatry. 2010 Oct;18(5):391-3. doi: 10.3109/10398562.2010.500474.
Psychiatrists use biopsychosocial models in identifying aetiological factors in assessing their patients and similar approaches in planning management. Models in decision making will be influenced by previous experience, training, age and gender, among other factors. Critical thinking and evidence base are both important components in the process of reaching clinical decisions. Expected outcome of treatment may be another factor. The way we think influences our decision making, clinical or otherwise. With patients expecting and taking larger roles in their own management, there needs to be a shift towards patient-centred care in decision making.
Further exploration in how clinical decisions are made by psychiatrists is necessary. An understanding of the manner in which therapeutic alliances are formed between the clinician and the patient is necessary to understand decision making.
精神科医生在评估患者时使用生物心理社会模型来识别病因因素，并在规划治疗方案时采用类似方法。决策模型会受到既往经验、培训、年龄和性别等多种因素的影响。批判性思维和循证基础都是做出临床决策过程中的重要组成部分。治疗的预期结果可能是另一个因素。我们思考的方式会影响我们的决策，无论是临床决策还是其他决策。随着患者在自身治疗中期望发挥更大作用并承担更多责任，在决策过程中需要向以患者为中心的护理模式转变。
有必要进一步探索精神科医生是如何做出临床决策的。了解临床医生与患者之间形成治疗联盟的方式对于理解决策过程很有必要。
