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一种用于膝关节骨关节炎管理的个性化共享决策工具。

A Personalized Shared Decision-Making Tool for Osteoarthritis Management of the Knee.

作者信息

Johnson Charla B

机构信息

Charla B. Johnson, DNP, RN-BC, ONC, Franciscan Missionaries of Our Lady Health System, Baton Rouge, LA; and Movement is LifeTM Executive Steering Committee, Warsaw, Indiana.

出版信息

Orthop Nurs. 2021;40(2):64-70. doi: 10.1097/NOR.0000000000000739.

Abstract

Shared decision making (SDM) is a key component of patient-centered care where clinical evidence and the patient's preference and values are considered. Physical activity and weight loss are often recommendations in the treatment plan, especially in mild to moderate stage of osteoarthritis (OA). Movement is Life™ created an innovative SDM tool providing a framework for patient-centered discussions. The tool leverages an underlying Markov Model and represents the likely pain, activity levels, and lost productivity at three future time points. Comparing the patient's likely progression depending on treatment choices to doing nothing, the patient has an illustration of their future state. The tool provides a consistent communication pathway and may reduce disparities by addressing unconscious bias. Orthopaedic nurses can be a catalyst for change in the clinic setting by providing education, counseling, and health coaching to promote physical activity and weight management as a recommended treatment option for early OA symptom management.

摘要

共同决策(SDM)是以患者为中心的医疗护理的关键组成部分,其中会考虑临床证据以及患者的偏好和价值观。身体活动和体重减轻通常是治疗方案中的建议,尤其是在骨关节炎(OA)的轻度至中度阶段。“运动即生命”(Movement is Life™)创建了一种创新的共同决策工具,为以患者为中心的讨论提供了一个框架。该工具利用了一个潜在的马尔可夫模型,并呈现了未来三个时间点可能出现的疼痛、活动水平和生产力损失情况。将根据治疗选择与不采取任何措施相比患者可能的病情进展进行比较,患者可以了解自己的未来状况。该工具提供了一条一致的沟通途径,并且通过解决无意识偏见可能会减少差异。骨科护士可以通过提供教育、咨询和健康指导,促进身体活动和体重管理,将其作为早期OA症状管理的推荐治疗选择,从而在临床环境中成为变革的推动者。

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What's the Role of Time in Shared Decision Making?时间在共同决策中的作用是什么?
AMA J Ethics. 2020 May 1;22(5):E416-422. doi: 10.1001/amajethics.2020.416.
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Non-operative treatment options for knee osteoarthritis.膝关节骨关节炎的非手术治疗选择
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Intra-articular treatment options for knee osteoarthritis.膝关节骨关节炎的关节内治疗选择。
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