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马来西亚的共享决策:立法、患者参与、实施情况以及 COVID-19 的影响。

Shared decision-making in Malaysia: Legislation, patient involvement, implementation and the impact of COVID-19.

机构信息

Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2022 Jun;171:89-92. doi: 10.1016/j.zefq.2022.04.020. Epub 2022 May 21.

Abstract

Shared decision making (SDM) activities in Malaysia began around 2010. The rise in the numbers of patients with chronic disease in Malaysia underscores a growing need for doctors to practice patient-centred care and SDM as more Malaysians come into regular contact with health decision-making scenarios. Recent guidelines for medical professionalism have emphasized that options and risks be discussed in consultations, especially for procedures with risk of adverse outcomes. Although SDM is not legally required, principles of SDM are applied in legal judgements on informed consent. Research on SDM has grown to include the adoption of patient and public involvement in research, an increased emphasis on incorporating local cultural values in SDM, and implementation of SDM in Malaysia's health system and organizational culture. While COVID-19 hindered the progress of SDM research, one positive development was that vaccination choices heightened public consciousness about personal decisional autonomy and the need to discuss pros and cons with doctors before making a medical decision.

摘要

马来西亚的共享决策(SDM)活动始于 2010 年左右。马来西亚慢性病患者人数的增加,突显了医生需要实践以患者为中心的护理和 SDM,因为越来越多的马来西亚人经常接触到与健康决策相关的情况。最近的医学专业准则强调,应在咨询中讨论各种选择和风险,尤其是对于存在不良后果风险的程序。虽然 SDM 没有法律要求,但 SDM 的原则适用于关于知情同意的法律判决。SDM 的研究不断发展,包括采用患者和公众参与研究,更加注重在 SDM 中融入当地文化价值观,以及在马来西亚的卫生系统和组织文化中实施 SDM。虽然 COVID-19 阻碍了 SDM 研究的进展,但一个积极的发展是,疫苗接种选择提高了公众对个人决策自主性的认识,以及在做出医疗决策之前与医生讨论利弊的必要性。

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