Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
Inform Health Soc Care. 2023 Jan 2;48(1):68-79. doi: 10.1080/17538157.2022.2054344. Epub 2022 Mar 29.
Shared decision making is a patient-centered clinical decision-making process that allows healthcare workers to share the existing empirical medical outcomes with patients before making critical decisions. This study aims to explore a project in a medical center of developing a mobile SDM in Taiwan. Chi Mei Medical Center developed the mobile SDM platform and conducted a survey of evaluation from healthcare workers. A three-tier platform that based on cloud infrastructure with seven functionalities was developed. The survey revealed that healthcare workers with sufficient SDM knowledge have an antecedent effect on the three perceptive factors of acceptance of mobile SDM. Resistance to change and perceived ease of use show significant effect on behavioral intention. We provided a comprehensive architecture of mobile SDM and observed the implementation in a medical center. The majority of healthcare workers expressed their acceptancem; however, resistance to change still present. It is, therefore, necessary to be eliminated by continuously promoting activities that highlight the advantages of the Mobile SDM platform. In clinical practice, we validated that the mobile SDM provides patients and their families with an easy way to express their concerns to healthcare workers improving significantly their relationship with each other.
共享决策是一种以患者为中心的临床决策过程,它使医疗保健工作者能够在做出关键决策之前与患者分享现有的经验医学结果。本研究旨在探讨台湾一家医疗中心开发移动共享决策支持系统的项目。奇美医疗财团法人奇美医学中心开发了移动共享决策支持系统平台,并对医疗保健工作者进行了评估调查。该平台基于云基础设施开发了具有七种功能的三层平台。调查显示,具有充足共享决策支持系统知识的医疗保健工作者对移动共享决策支持系统的三个感知因素的接受程度具有先行影响。对变革的抵制和感知易用性对行为意向有显著影响。我们提供了移动共享决策支持系统的综合架构,并观察了在医疗中心的实施情况。大多数医疗保健工作者表示接受,但对变革的抵制仍然存在。因此,有必要通过不断开展活动来突出移动共享决策支持系统平台的优势来消除这种抵制。在临床实践中,我们验证了移动共享决策支持系统为患者及其家属提供了一种与医疗保健工作者表达关切的简便方法,显著改善了他们之间的关系。