Lerret Stacee M, Haglund Kristin A, Johnson Norah L
J Pediatr Health Care. 2016 Jul-Aug;30(4):374-80. doi: 10.1016/j.pedhc.2015.10.001. Epub 2015 Nov 4.
The Institute of Medicine prioritizes active family and clinician participation in treatment decisions, known as shared decision making (SDM). In this article we report the decision-making experiences for parents of children who had a solid organ transplant.
We performed a prospective longitudinal mixed methods study at five major U.S. children's medical centers. Qualitative interview data were obtained at 3 weeks, 3 months, and 6 months after hospital discharge following the child's transplant.
Forty-eight parents participated in the study. Three themes were identified: (a) Parents expect to participate in SDM; (b) parents seek information to support their participation in SDM; and (c) attributes of providers' professional practice facilitates SDM. SDM was facilitated when providers were knowledgeable, transparent, approachable, accessible, dependable, and supportive.
Parents expect to participate in SDM with their transplant team. Health care providers can intentionally use the six key attributes to engage parents in SDM. The results provide a framework to consider enhancing SDM in other chronic illness populations.
美国医学研究所将家庭和临床医生积极参与治疗决策列为优先事项，这被称为共同决策（SDM）。在本文中，我们报告了实体器官移植患儿家长的决策经历。
我们在美国五家主要的儿童医疗中心进行了一项前瞻性纵向混合方法研究。定性访谈数据是在患儿移植出院后的3周、3个月和6个月收集的。
48位家长参与了该研究。确定了三个主题：（a）家长期望参与共同决策；（b）家长寻求信息以支持他们参与共同决策；（c）医疗服务提供者专业实践的属性促进了共同决策。当医疗服务提供者知识渊博、透明、平易近人、可接触、可靠且给予支持时，共同决策得到了促进。
家长期望与移植团队共同参与共同决策。医疗保健提供者可以有意利用这六个关键属性让家长参与共同决策。研究结果提供了一个框架，可用于考虑在其他慢性病群体中加强共同决策。
