Adams Richard C, Levy Susan E
Pediatrics. 2017 Jun;139(6). doi: 10.1542/peds.2017-0956.
Shared decision-making (SDM) promotes family and clinician collaboration, with ultimate goals of improved health and satisfaction. This clinical report provides a basis for a systematic approach to the implementation of SDM by clinicians for children with disabilities. Often in the discussion of treatment plans, there are gaps between the child's/family's values, priorities, and understanding of perceived "best choices" and those of the clinician. When conducted well, SDM affords an appropriate balance incorporating voices of all stakeholders, ultimately supporting both the child/family and clinician. With increasing knowledge of and functional use of SDM skills, the clinician will become an effective partner in the decision-making process with families, providing family-centered care. The outcome of the process will support the beneficence of the physician, the authority of the family, and the autonomy and well-being of the child.
共同决策（SDM）促进家庭与临床医生的合作，其最终目标是改善健康状况并提高满意度。本临床报告为临床医生对残疾儿童实施共同决策提供了一种系统方法的基础。在讨论治疗方案时，儿童/家庭的价值观、优先事项以及对“最佳选择”的理解与临床医生的理解之间往往存在差距。如果实施得当，共同决策能在纳入所有利益相关者意见的基础上实现适当平衡，最终既支持儿童/家庭，也支持临床医生。随着对共同决策技能的了解和实际应用不断增加，临床医生将成为与家庭在决策过程中的有效伙伴，提供以家庭为中心的护理。这一过程的结果将支持医生的善举、家庭的权威以及儿童的自主性和福祉。
