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共同决策与患者决策辅助工具:夏威夷医生的知识、态度和实践

Shared decision making and patient decision aids: knowledge, attitudes, and practices among Hawai'i physicians.

作者信息

Alden Dana L, Friend John, Chun Maria B J

机构信息

Shidler College of Business, University of Hawai'i at Manoa, Honolulu, HI (D.L.A.).

出版信息

Hawaii J Med Public Health. 2013 Nov;72(11):396-400.

PMID:24251086
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3831568/
Abstract

As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai'i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai'i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai'i physicians are promising.

摘要

随着医疗保健领域向以患者为中心的护理(PCC)发展,人们越来越重视患者决策辅助工具在促进共同决策(SDM)方面的益处。本研究提供了夏威夷医生关于患者决策辅助工具(DAs)的知识、态度和实践(KAP)的基线测量。邀请了夏威夷州的医生完成一项调查,评估他们对DAs临床使用的知识、态度和实践。分析了174份有效调查问卷。报告的DAs知晓率和使用率较低,但对SDM益处的认识和对使用DAs的接受度非常高。实施DAs的主要感知障碍是缺乏认识、缺乏资源以及医生了解DA技术的时间有限。然而,绝大多数受访者报告称,DAs可以通过提高知识水平(88%)、提高对咨询过程的满意度(81%)和提高依从性(74%)来增强患者的能力。在目前使用DAs的医生中,使用宣传册或选项矩阵表是最常见的辅助工具。然而,推荐的主要DA格式是诊所使用的纸质宣传册(75%)和诊所外使用的交互式在线网站程序(73.5%)。鉴于对PCC模式的日益重视以及许多患者参与医疗决策过程的公认愿望,夏威夷医生对SDM和使用DAs的积极反应很有前景。

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