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基于目标的共同决策:开发一个综合模型。

Goal-Based Shared Decision-Making: Developing an Integrated Model.

作者信息

Elwyn Glyn, Vermunt Neeltje Petronella Catharina Anna

机构信息

The Dartmouth Institute for Health Policy and Clinical Practice - Williamson Translational Research Building, Dartmouth College, Hanover, USA.

Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Nijmegen, the Netherlands.

出版信息

J Patient Exp. 2020 Oct;7(5):688-696. doi: 10.1177/2374373519878604. Epub 2019 Oct 17.

Abstract

OBJECTIVE

Definitions of shared decision-making (SDM) have largely neglected to consider goal setting as an explicit component. Applying SDM to people with multiple long-term conditions requires attention to goal setting. We propose an integrated model, which shows how goal setting, at 3 levels, can be integrated into the 3-talk SDM model.

METHOD

The model was developed by integrating 2 published models.

RESULTS

An integrated, goal-based SDM model is proposed and applied to a patient with multiple, complex, long-term clinical conditions to illustrate the use of a visualization tool called a Goal Board. A Goal Board prioritizes collaborative goals and aligns goals with interventional options.

CONCLUSION

The model provides an approach to achieve person-centered decision-making by not only eliciting and prioritizing goals but also by aligning prioritized goals and interventions.

PRACTICE IMPLICATIONS

Further research is required to evaluate the utility of the proposed model.

摘要

目的

共享决策(SDM)的定义在很大程度上忽略了将目标设定视为一个明确的组成部分。将共享决策应用于患有多种长期病症的人群需要关注目标设定。我们提出了一个综合模型,该模型展示了三个层面的目标设定如何能够融入三对话共享决策模型。

方法

该模型是通过整合两个已发表的模型而开发的。

结果

提出了一个基于目标的综合共享决策模型,并将其应用于一位患有多种复杂长期临床病症的患者,以说明一种名为目标板的可视化工具的使用。目标板对协作目标进行优先级排序,并使目标与干预选项保持一致。

结论

该模型提供了一种实现以患者为中心的决策的方法,不仅通过引出目标并对其进行优先级排序,还通过使优先目标和干预措施保持一致来实现。

实践意义

需要进一步研究以评估所提出模型的效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7429/7705836/c6e5b8794214/10.1177_2374373519878604-fig1.jpg

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