Danner Marion, Geiger Friedemann, Wehkamp Kai, Rueffer Jens Ulrich, Kuch Christine, Sundmacher Leonie, Skjelbakken Tove, Rummer Anne, Novelli Anna, Debrouwere Marie, Scheibler Fueloep
SHARE TO CARE Team, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
SHARE TO CARE Team, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany.
BMJ Open. 2020 Oct 10;10(10):e037575. doi: 10.1136/bmjopen-2020-037575.
Shared decision-making (SDM) is not yet widely used when making decisions in German hospitals. Making SDM a reality is a complex task. It involves training healthcare professionals in SDM communication and enabling patients to actively participate in communication, in addition to providing sound, easy to understand information on treatment alternatives in the form of evidence-based patient decision aids (EbPDAs). This project funded by the German Innovation Fund aims at designing, implementing and evaluating a multicomponent, large-scale and integrative SDM programme-called SHARE TO CARE (S2C)-at all clinical departments of a University Hospital Campus in Northern Germany within a 4-year time period.
S2C tackles the aforementioned components of SDM: (1) training physicians in SDM communication, (2) activating and empowering patients, (3) developing EbPDAs in the most common/relevant diseases and (4) training other healthcare professionals in SDM coaching. S2C is designed together with patients and providers. The physicians' training programme entails an online and an in situ training module. The decision coach training is based on a similar but less comprehensive approach. The development of online EbPDAs follows the International Patient Decision Aid Standards and includes written, graphical and video-based information. Validated outcomes of SDM implementation are measured in a preintervention and postintervention evaluation design. Process evaluation accompanies programme implementation. Health economic impact of the intervention is investigated using a propensity-score-matched approach based on potentially preference-sensitive hospital decisions.
Ethics committee review approval has been obtained from Medical Ethics Committee of the Medical Faculty of the Christian-Albrechts-University Kiel. Project information and results will be disseminated at conferences, on project-hosted websites at University Hospital Medical Center Schleswig Holstein and by S2C as well as in peer-reviewed and professional journals.
在德国医院进行决策时，共同决策（SDM）尚未得到广泛应用。将共同决策变为现实是一项复杂的任务。这涉及到对医疗保健专业人员进行共同决策沟通方面的培训，并使患者能够积极参与沟通，此外还需以基于证据的患者决策辅助工具（EbPDAs）的形式提供合理、易于理解的治疗方案信息。这个由德国创新基金资助的项目旨在在四年时间内，在德国北部一个大学校园医院的所有临床科室设计、实施和评估一个多组件、大规模且综合性的共同决策项目——称为“分享关爱”（S2C）。
S2C解决了共同决策的上述组成部分：（1）对医生进行共同决策沟通培训；（2）激活并赋予患者权力；（3）针对最常见/相关疾病开发EbPDAs；（4）对其他医疗保健专业人员进行共同决策指导方面的培训。S2C是与患者和提供者共同设计的。医生培训项目包括一个在线培训模块和一个现场培训模块。决策指导培训基于类似但不太全面的方法。在线EbPDAs的开发遵循国际患者决策辅助工具标准，包括书面、图形和视频信息。在干预前和干预后评估设计中测量共同决策实施的有效结果。过程评估伴随项目实施。使用基于潜在偏好敏感的医院决策的倾向得分匹配方法来研究干预的健康经济影响。
已获得基尔基督教 - 阿尔布雷希茨大学医学院医学伦理委员会的伦理委员会审查批准。项目信息和结果将在会议上、石勒苏益格 - 荷尔斯泰因大学医院医疗中心的项目网站上、由S2C进行传播，并发表在同行评审的专业期刊上。
