与患者一起做决定,而不是为患者做决定:过敏和免疫学的共同决策
Douglas P Mack1, Matthew Greenhawt2, Don A Bukstein3
1Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
概括
共享决策 (SDM) 对于以患者为中心的护理至关重要,但临床医生报告和患者经验之间存在差距. 本综述探讨了导致这种差异的因素,以改善对过敏性疾病的SDM实施.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
- 临床决策 - 临床决策
背景情况:
- 共享决策 (SDM) 将患者的偏好与医疗证据集成为偏好敏感的护理.
- 最近的指导方针强调SDM,但临床医生的接受和一致的实施仍然是挑战.
- 在临床医生自我报告的SDM坚持和患者感知到的经验之间存在着显著的差距.
研究的目的:
- 批判性地检查导致临床医生和患者对SDM的看法之间的差异的因素.
- 确定在过敏性疾病中有效实施SDM的障碍和促进因素.
- 为弥合认知差距和推进以患者为中心的护理提供见解.
主要方法:
- 文献综述检查了影响SDM的因素.
- 对临床医生的态度,行为,系统障碍和患者期望的分析.
- 专注于过敏性疾病,包括食物过敏,喘和eosinophilic食道炎.
主要成果:
- 临床医生对SDM的自我评估往往高估了其实际实施.
- 患者的经验表明,在临床接触期间SDM应用的不一致性.
- 系统性,态度和患者相关的因素有助于观察到的差异.
结论:
- 解决临床医生的认知和患者体验之间的不一致对于有效的SDM至关重要.
- 弥合这一差距需要理解和减轻已识别的障碍.
- 确保SDM是一个有形的现实,而不仅仅是一个概念,对于过敏疾病中以患者为中心的护理至关重要.
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