Center for Shared Decision Making, Department of Clinical Oncology, Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Center for Shared Decision Making, Department of Clinical Oncology, Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Z Evid Fortbild Qual Gesundhwes. 2022 Jun;171:36-41. doi: 10.1016/j.zefq.2022.04.005. Epub 2022 May 21.
Current Danish legislation empowers patients in securing their rights, but there are no present legislative developments in Denmark to support patient involvement. Policy initiatives within health care, however, show positive trends by, for example, including recommendations for shared decision making (SDM) in national clinical guidelines and the allocation of resources to fund projects in SDM. Within the last five years, three out of five regions have launched centers in patient involvement and SDM to focus on training, implementation of patient decision aids (PtDAs) and to foster the cultural change in SDM. A national dissemination of a template for easy building of PtDAs accessible via an online platform is one of the latest initiatives.
Although the political discourse on SDM is gathering speed, an unclear definition and purpose of SDM is a barrier to real-life implementation. Politicians, leaders and clinicians seem to be moving at different paces and in different directions and are lacking consensus on SDM as a paradigm requiring training, leadership and a patient-centered mindset.
Many relevant initiatives are underway. However, SDM is also challenged by the lack of legislation and a central push for real SDM implementation in Denmark.
丹麦现行法律赋予患者保障其权利的权力,但目前丹麦没有立法发展来支持患者参与。然而,医疗保健领域的政策举措显示出积极的趋势,例如,在国家临床指南中纳入了共同决策(SDM)的建议,并为 SDM 项目分配资源。在过去五年中,五个地区中有三个地区已经启动了患者参与和 SDM 中心,专注于培训、实施患者决策辅助工具(PtDAs),并推动 SDM 中的文化变革。最近的一项举措是在全国范围内推广一个模板,以便通过在线平台轻松构建 PtDAs。
尽管 SDM 的政治讨论正在加速,但 SDM 定义和目的不明确是其实际实施的障碍。政治家、领导人和临床医生似乎在以不同的速度和方向前进,并且在 SDM 作为需要培训、领导力和以患者为中心思维模式的范式方面缺乏共识。
许多相关倡议正在进行中。然而,SDM 也面临着缺乏立法和丹麦真正推动 SDM 实施的挑战。