Wood Fiona, Phillips Katie, Edwards Adrian, Elwyn Glyn
Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, UK.
Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, UK.
Patient Educ Couns. 2017 Mar;100(3):456-464. doi: 10.1016/j.pec.2016.09.016. Epub 2016 Sep 22.
We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making.
Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English.
Analysis revealed the difficulties with introducing a written decision aid into an interpreted consultation. The extra discussion needed between the clinician and interpreter around the principles and purpose of shared decision making and instructions regarding the Option Grid decision aid proved challenging and difficult to manage. Discussion of treatment options while using an Option Grid decision aid was predominantly done between clinician and interpreter. The patient appeared to have little involvement in discussion of treatment options.
Patients were not active participants within the discussion. Further work needs to be done on how shared decision making can be achieved within interpreted consultations.
Option Grid decision aids are not being used as intended in interpreted consultations.
我们旨在观察在有口译员在场的情况下，用于临床会诊的Option Grid™决策辅助工具是如何被使用的，并评估其使用对共同决策的影响。
有来自患者、临床医生（一名物理治疗师）和口译员之间关于膝骨关节炎的三次临床会诊的数据。临床医生接受了使用Option Grid决策辅助工具的培训并使用了该工具。会诊进行了录音、转录，并由独立翻译人员翻译成英文。
分析揭示了在口译会诊中引入书面决策辅助工具的困难。临床医生和口译员之间围绕共同决策的原则和目的以及关于Option Grid决策辅助工具的说明进行的额外讨论被证明具有挑战性且难以管理。在使用Option Grid决策辅助工具时，治疗方案的讨论主要在临床医生和口译员之间进行。患者似乎很少参与治疗方案的讨论。
患者在讨论中并非积极参与者。需要进一步开展工作，以探讨如何在口译会诊中实现共同决策。
在口译会诊中，Option Grid决策辅助工具未按预期使用。
