Terre Haute Regional Hospital, 3901 South 7th Street, Terre Haute, IN 47802, USA; Indiana University School of Medicine, Terre Haute, IN, USA.
Surg Clin North Am. 2019 Oct;99(5):1019-1027. doi: 10.1016/j.suc.2019.06.014. Epub 2019 Jul 26.
Shared decision making requires the exchange of information from the patient and the surgeon (and ideally involves the expertise of the entire multidisciplinary team) to determine the medical and/or surgical treatment that best aligns with the patient's goals and values. Should the surgical patient wish to transition to end-of-life care, the transition to comfort-focused care is within the scope of practice for surgeons. Incorporating the expertise of other health care professionals is an important consideration for whole-patient care. Integrating primary palliative care into surgical practice can help mitigate unnecessary suffering and allow a smoother transition to comfort-focused care.
共同决策需要医患双方（理想情况下还应包括整个多学科团队的专业知识）进行信息交流，以确定最符合患者目标和价值观的医疗和/或手术治疗方案。如果手术患者希望过渡到临终关怀，那么向以舒适为中心的护理过渡则属于外科医生的执业范围。整合其他医疗保健专业人员的专业知识是全面患者护理的重要考虑因素。将初级姑息治疗纳入外科实践可以帮助减轻不必要的痛苦，并实现更顺利地向以舒适为中心的护理过渡。
