Hargraves Ian, LeBlanc Annie, Shah Nilay D, Montori Victor M
Ian Hargraves is a service designer in the Knowledge and Evaluation Research Unit at Mayo Clinic, in Rochester, Minnesota.
Annie LeBlanc is an assistant professor of health services research and an investigator in the Knowledge and Evaluation Research Unit at Mayo Clinic.
Health Aff (Millwood). 2016 Apr;35(4):627-9. doi: 10.1377/hlthaff.2015.1354.
The growth of shared decision making has been driven largely by the understanding that patients need information and choices regarding their health care. But while these are important elements for patients who make decisions in partnership with their clinicians, our experience suggests that they are not enough to address the larger issue: the need for the patient and clinician to jointly create a course of action that is best for the individual patient and his or her family. The larger need in evidence-informed shared decision making is for a patient-clinician interaction that offers conversation, not just information, and care, not just choice.
共同决策的发展很大程度上是由于人们认识到患者需要有关其医疗保健的信息和选择。但是,虽然这些对于与临床医生共同做出决策的患者来说是重要因素,但我们的经验表明,这些还不足以解决更大的问题:患者和临床医生需要共同制定出最适合个体患者及其家庭的行动方案。循证共同决策中更大的需求是患者与临床医生之间的互动,这种互动提供的是对话而非仅仅是信息,是关怀而非仅仅是选择。