Myckatyn Terence M, Parikh Rajiv P, Lee Clara, Politi Mary C
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
Department of Plastic and Reconstructive Surgery, Ohio State University, Columbus, Ohio.
Plast Reconstr Surg Glob Open. 2020 Feb 6;8(2):e2645. doi: 10.1097/GOX.0000000000002645. eCollection 2020 Feb.
Patient-centered care is a hallmark of quality in healthcare. It is defined as care that is respectful of, and responsive to, individual patient preferences, needs, and values, while ensuring patients are informed and engaged in the treatment decision-making process.
We reviewed the literature and drew upon our own experiences to study the implementation of tools intended to facilitate shared decision-making in breast reconstruction.
For women with breast cancer, decision-making about breast reconstruction is often a challenging and perplexing process. The variety of choices available regarding timing and type of reconstruction and the unique individual patient and clinical treatment variables to consider can further complicate decisions. Accordingly, strategies to facilitate the decision-making process and enable patients and clinicians to make high-quality decisions about breast reconstruction are an essential component of comprehensive breast cancer care. Shared decision making is one proposed model to support informed and preference-sensitive decision-making in line with the principles of patient-centered care. Despite an emerging level of interest in shared decision making, there remains a lack of clarity regarding what the process involves and how to effectively implement it into clinical practice.
Thus, widespread adoption of shared decision making remains lacking in clinical practice for women considering postmastectomy breast reconstruction. To address these gaps, this article reviews the principles of shared decision making, explores ways shared decision making can be utilized for patients who are candidates for breast reconstruction, and provides a practical overview to facilitate implementation of shared decision making into clinical practice.
以患者为中心的护理是医疗保健质量的一个标志。它被定义为尊重并响应个体患者的偏好、需求和价值观的护理，同时确保患者了解情况并参与治疗决策过程。
我们查阅了文献并借鉴自身经验，研究旨在促进乳房重建中共同决策的工具的实施情况。
对于乳腺癌女性患者而言，乳房重建的决策往往是一个具有挑战性且令人困惑的过程。关于重建时机和类型的多种选择，以及需要考虑的独特个体患者和临床治疗变量，可能会使决策进一步复杂化。因此，促进决策过程并使患者和临床医生能够就乳房重建做出高质量决策的策略，是综合乳腺癌护理的重要组成部分。共同决策是一种提出的模式，旨在根据以患者为中心的护理原则，支持基于充分信息和偏好敏感的决策。尽管对共同决策的兴趣日益浓厚，但对于该过程涉及的内容以及如何有效地将其应用于临床实践，仍缺乏明确认识。
因此，对于考虑乳房切除术后乳房重建的女性患者，临床实践中仍缺乏对共同决策的广泛采用。为了填补这些空白，本文回顾了共同决策的原则，探讨了共同决策可用于乳房重建候选患者的方式，并提供了一个实用概述，以促进将共同决策应用于临床实践。
