共同决策和心血管健康:美国心脏协会的科学声明
Circulation
|August 14, 2023
概括
在心血管保健领域的共同决策改善了结果,并促进了公平. 策略包括临床医生教育,决策辅助和团队参与,以克服实践障碍.
科学领域:
- 心血管医学
- 医疗服务研究
- 医疗公平
背景情况:
- 共享决策 (SDM) 对于以患者为中心的心血管保健至关重要,旨在改善健康结果和公平.
- 虽然在指导方针中得到了认可,但由于患者,临床医生和系统层面的障碍,SDM在心血管实践中的实施不足.
- 正式的模型和对心血管护理的评估仍在发展中.
研究的目的:
- 审查SDM对心血管结果的影响的证据.
- 突出SDM作为健康公平的驱动力.
- 确定促进心血管保健中的多层次解决方案.
主要方法:
- 这份科学声明综合了有关心血管健康的共享决策的当前文献.
- 它研究了有效实施的策略,包括临床医师培训和患者决策辅助工具.
- 审查解决了挑战,并提出了多层面的解决方案,以便更广泛地采用.
主要成果:
- 证据表明SDM对心血管结果的积极影响,尽管研究正在增长.
- 通过将患者的价值观和需求放在中心, SDM 有潜力显著推进健康公平.
- 有效的策略包括临床医生的沟通技巧,多学科团队,决策指导和可访问的患者决策辅助工具.
结论:
- 实施共享决策对于高质量,以价值为基础的心血管保健和实现健康公平至关重要.
- 解决政策,补偿,系统基础设施,临床医生培训和患者参与对于成功采用SDM至关重要.
- 需要多层次的解决方案, 充分支持患者和临床医生在SDM, 最终改善心血管结果和公平.
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