Hahlweg Pola
Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Urologie. 2025 Jul 21. doi: 10.1007/s00120-025-02638-x.
The aim of this article is to present shared decision making as a practical concept for urology. It describes a communication process in which patients and physicians share their respective perspective and expertise in order to jointly make an informed decision that is suitable for the individual patient. This makes it an important component of person-centered healthcare and is demanded by many patients and healthcare policy makers. Shared decision making can have a positive impact on patient knowledge and satisfaction. In urology, there are numerous decision-making situations in which shared decision making is indicated. At the same time, it is unclear how often shared decision making takes place in routine urological care and there are barriers to implementation on the part of physicians, patients and the organizational and system level. An appropriate attitude and communication skills as well as an awareness of the preference-sensitive decisions to be made are important prerequisites for shared decision making. Approaches such as the "Three Talks" model can be used to guide consultations. In addition, other measures such as patient decision aids, patient activation strategies, and training for physicians can support shared decision making in practice. Targeted approaches and reliable implementation in routine care will be important topics for the future of shared decision making.
本文旨在将共同决策作为泌尿外科的一个实用概念进行介绍。它描述了一个沟通的过程,在此过程中患者和医生分享各自的观点和专业知识,以便共同做出适合个体患者的明智决策。这使其成为以患者为中心的医疗保健的一个重要组成部分,并且受到许多患者和医疗政策制定者的要求。共同决策可对患者的知识水平和满意度产生积极影响。在泌尿外科领域,有许多决策情形都适合采用共同决策。与此同时,目前尚不清楚在常规泌尿外科护理中共同决策的发生频率如何,并且在医生、患者以及组织和系统层面都存在实施障碍。恰当的态度和沟通技巧以及对即将做出的偏好敏感型决策的认知是共同决策的重要前提条件。诸如“三次谈话”模式之类的方法可用于指导会诊。此外,其他措施,如患者决策辅助工具、患者激活策略以及医生培训等,可在实践中支持共同决策。在常规护理中采取有针对性的方法并可靠地实施,将是共同决策未来的重要议题。