一般医生在多大程度上让患者参与决策? 对使用OPTION工具的研究进行系统审查
Dirk T Ubbink1, Fadi Shamoun2, Steyn Heuvelsland2
1Department of Surgery, Amsterdam University Medical Center at the University of Amsterdam, Location AMC, Amsterdam, The Netherlands.
Primary health care research & development
|July 31, 2025
概括
一般医生 (GPs) 显示患者参与决策的程度很低,随着时间的推移,改善的程度很小. 干预措施可以加强共享决策 (SDM),突出需要更多的全科医生和患者教育.
科学领域:
- 初级医疗保健研究 研究初级医疗保健
- 以患者为中心的护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 共享决策 (SDM) 对于初级卫生保健中以患者为中心的护理至关重要.
- 之前的审查表明,患者在医疗决策中显著缺乏参与.
- 观察患者参与决策 (OPTION) 工具是评估SDM的关键.
研究的目的:
- 系统地审查有关全科医生 (GPs) 在咨询期间患者参与的研究.
- 分析患者参与初级保健机构决策的程度.
主要方法:
- 在三个数据库中进行了全面的文献搜索,截至2023年11月.
- 包括使用初级医疗保健和OPTION-5或-12仪器的比较设计的研究.
- 研究选择,偏见评估和数据提取由两个独立研究人员进行.
主要成果:
- 包括29项研究 (2003-2022年),分析了年龄在33-53岁的全科医生.
- 基线OPTION分数表明SDM较低,中位数为16 (范围为1.5-57.2).
- SDM干预显著提高了OPTION分数,达到28.5的中位数 (范围为16-83).
结论:
- 一般医生的SDM总体水平仍然很低,在过去十年中观察到的改善很小.
- 旨在促进SDM的干预措施已经证明对患者参与有积极的影响.
- 增加一般医生和患者的教育和资源对于推进SDM实践至关重要.
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