Grabinski Victoria F, Myckatyn Terence M, Lee Clara N, Philpott-Streiff Sydney E, Politi Mary C
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Health Equity. 2018 Sep 1;2(1):234-238. doi: 10.1089/heq.2018.0020. eCollection 2018.
Shared decision-making (SDM) is a process through which patients and providers collaborate to select a treatment option that aligns with patients' preferences and clinical context. SDM can improve patients' decision quality and satisfaction. However, vulnerable populations face barriers to participation in SDM, which exacerbates disparities in decision quality. This perspective article discusses SDM with vulnerable patients, using examples from patients who made decisions about postmastectomy breast reconstruction. We offer several strategies for clinical practice, medical education, and research to ensure that movements to engage patients in SDM do not exclude already marginalized groups.
共同决策（SDM）是一个患者与医疗服务提供者合作选择符合患者偏好和临床情况的治疗方案的过程。共同决策可以提高患者的决策质量和满意度。然而，弱势群体在参与共同决策方面面临障碍，这加剧了决策质量的差异。这篇观点文章以接受乳房切除术后乳房重建决策的患者为例，讨论了与弱势患者的共同决策。我们为临床实践、医学教育和研究提供了几种策略，以确保让患者参与共同决策的行动不会将已经处于边缘地位的群体排除在外。
