St Paul's Hospital, Vancouver, British Columbia, Canada; School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
Faculty of Health Sciences, University of Ottawa, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Can J Cardiol. 2021 Jul;37(7):1054-1063. doi: 10.1016/j.cjca.2021.02.022. Epub 2021 Mar 9.
Innovations in the treatment of valvular heart disease have transformed treatment options for people with valvular heart disease. In this rapidly evolving environment, the integration of patients' perspectives is essential to close the potential gap between what can be done and what patients want. Shared decision-making (SDM) and the measurement of patient-reported outcomes (PROs) are two strategies that are in keeping with this aim and gaining significant momentum in clinical practice, research, and health policy. SDM is a process that involves an individualised, intentional, and bidirectional exchange among patients, family, and health care providers that integrates patients' preferences, values, and priorities to reach a high-quality consensus treatment decision. SDM is widely endorsed by international valvular heart disease guidelines and increasingly integrated in health policy. Patient decision aids are evidence-based tools that facilitate SDM. The measurement of PROs-an umbrella term that refers to the standardised reporting of symptoms, health status, and other domains of health-related quality of life-provides unique data that come directly from patients to inform clinical practice and augment the reporting of quality of care. Sensitive and validated instruments are available to capture generic, dimensional, and disease-specific PROs in patients with valvular heart disease. The integration of PROs in clinical care presents significant opportunities to help guide treatment decision and monitor health status. The integration of patients' perspectives promotes the shift to patient-centred care and optimal outcomes, and contributes to transforming the way we care for patients with valvular heart disease.
瓣膜性心脏病治疗领域的创新变革了瓣膜性心脏病患者的治疗选择。在这个快速发展的环境中,整合患者的观点对于缩小实际可行与患者期望之间的潜在差距至关重要。共同决策(SDM)和患者报告结局(PROs)的测量是与这一目标保持一致并在临床实践、研究和卫生政策中得到显著推动的两项策略。SDM 是一个涉及患者、家属和医疗保健提供者之间个体化、有目的和双向交流的过程,其中整合了患者的偏好、价值观和优先事项,以达成高质量的共识治疗决策。SDM 得到了国际瓣膜性心脏病指南的广泛认可,并逐渐纳入卫生政策中。患者决策辅助工具是促进 SDM 的循证工具。PROs 的测量——一个涵盖症状、健康状况和其他健康相关生活质量领域的标准化报告的总称——提供了直接来自患者的独特数据,用于指导临床实践并增强护理质量的报告。有敏感和经过验证的工具可用于捕获瓣膜性心脏病患者的通用、维度和疾病特异性 PROs。将 PROs 纳入临床护理中具有重要意义,可以帮助指导治疗决策和监测健康状况。整合患者的观点促进了向以患者为中心的护理和最佳结局的转变,并有助于改变我们对瓣膜性心脏病患者的护理方式。