传达参与决策的证据
Ronald M Epstein1, Brian S Alper, Timothy E Quill
1Rochester Center to Improve Communication in Health Care, Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14620, USA. ronald_epstein@urmc.rochester.edu
JAMA
|May 20, 2004
概括
对临床证据的有效沟通对于患者做出知情决策至关重要. 本综述强调了改善患者理解和参与的方法,尽管证据有限,但强调了共享决策和明确的沟通策略.
科学领域:
- 医学沟通 医学沟通
- 卫生识字 卫生识字
- 患者参与 患者参与
背景情况:
- 了解情况的患者积极参与护理,从而做出更好的决策和坚持治疗.
- 目前,缺乏基于证据的指导方针,用于与患者讨论临床证据.
- 有效的患者-临床医生沟通对于共同的医疗决策至关重要.
研究的目的:
- 确定有效的方法来向患者传达临床证据.
- 提高患者的理解,参与医疗决策和健康结果.
- 解决患者与临床医生的沟通中需要基于证据的指导方针的需求.
主要方法:
- 对MEDLINE (1966-2003) 和参考清单进行系统审查.
- 搜索关于临床医生与患者沟通的原始研究,并提出临床证据.
- 选了367篇摘要,并审查了51篇全文文章,确定了8项相关研究.
主要成果:
- 沟通方法包括一般术语,数字数据,图表和决策辅助工具.
- 在决策角色之前提出选项,并使用绝对风险是首选.
- 信息顺序,时间框架和患者人口统计学 (年龄,教育) 影响理解.
结论:
- 显著缺乏证据来指导医生分享临床证据.
- 建议侧重于了解患者的背景,建立伙伴关系,并讨论不确定性.
- 关键的沟通任务包括提供平衡的证据,明智的建议和检查理解.
相关概念视频
01:31Confirmation Biases
6.0K
The confirmation bias is the tendency to focus on information that confirms our existing beliefs and ignore information that is inconsistent with our expectations. For example, if you think that your professor is not very nice, you notice all of the instances of rude behavior exhibited by the professor while ignoring the countless pleasant interactions he is involved in on a daily basis. Have you ever fallen prey to the confirmation bias, either as the source or target of such bias?
6.0K
00:52Social Proof
24.9K
Social proof is a form of persuasion based on comparison and conformity. People compare their behavior and actions to what others are doing and will change to conform to do what their peers do.
24.9K
02:55The Evidence for Evolution
40.1K
Genetic variations accumulating within populations over generations give rise to biological evolution. Evolutionary changes can result in the formation of novel varieties and entire new species. These changes are responsible for the diverse forms of life inhabiting the planet. The evidence for evolution suggests that all living organisms descended from common ancestors.
40.1K
01:09Decision Making: P-value Method
5.8K
The process of hypothesis testing based on the P-value method includes calculating the P- value using the sample data and interpreting it.
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can...
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can...
5.8K
01:14Decision Making: Traditional Method
4.4K
The process of hypothesis testing based on the traditional method includes calculating the critical value, testing the value of the test statistic using the sample data, and interpreting these values.
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...
4.4K
01:06Legal Guidelines for Documentation
2.4K
The legal guidelines for nursing documentation are essential for ensuring accurate, professional, and ethical recording of patient care. The guidelines are discussed here:
2.4K