Godfrey Sarah, Barnes Alexis, Gao Jing, Sulistio Melanie S, Katz Jason N, Chuzi Sarah
Division of Cardiology, University of Texas Southwestern Medical Center Dallas, TX.
Division of Cardiology, University of Pittsburgh Medical Center Pittsburgh, PA.
US Cardiol. 2024 Sep 4;18:e13. doi: 10.15420/usc.2024.03. eCollection 2024.
Patients and clinicians in the cardiac intensive care unit (CICU) are often tasked with making high-stakes decisions about aggressive or life- sustaining therapies. Shared decision-making (SDM), a collaborative process where patients and clinicians work together to make medical decisions that are aligned with a patient's goals and values, is therefore highly relevant in the CICU, especially in the context of palliative or end-of-life decisions. Despite its importance, there are barriers to optimal integration and implementation of SDM. This review describes the fundamentals and models of SDM, the role of SDM in the CICU, and evidence-based strategies to promote SDM in the CICU.
心脏重症监护病房(CICU)的患者和临床医生常常面临着就积极治疗或维持生命的疗法做出高风险决策的任务。因此,共同决策(SDM),即患者和临床医生共同协作以做出符合患者目标和价值观的医疗决策的过程,在CICU中具有高度相关性,尤其是在姑息治疗或临终决策的背景下。尽管其很重要,但SDM的最佳整合与实施存在障碍。本综述描述了SDM的基本原理和模式、SDM在CICU中的作用以及在CICU中促进SDM的循证策略。