在治疗无并发性胆结石病的共享决策:一个横截面试点研究
Martin Alavi Treider1, Simone Kienlin2, Thomas J Fyhn3
1Department for Gastrointestinal Surgery Oslo University Hospital Mailbox 4950 Nydalen Oslo 0424 Norway Faculty of Medicine University of Oslo Oslo Norway.
概括
在胆结石疾病治疗中,共享决策 (SDM) 显示了适度的患者参与,尽管人们的看法各不相同. 较高的SDM分数与选择手术相关,表明需要改善护理的一致性.
科学领域:
- 医疗决策的制定 医疗决策的制定
- 手术患者护理手术患者护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 共享决策 (SDM) 对于无并发性胆结石疾病的治疗选择至关重要,在这种情况下,手术和保守的选择都是可行的.
- 鉴于可用的选择的安全性,患者的偏好是治疗决策的核心.
研究的目的:
- 评估患者参与无并发性胆结石病治疗的共同决策的程度.
- 为了比较患者,外科医生和外部观察者对SDM的看法.
主要方法:
- 在挪威外科门诊进行前性试点研究.
- 对视频录制的咨询和来自患者,外科医生和专家评价人的MAPPIN-SDM问卷数据的分析.
- 根据11项 (0-4) 计算的MAPPIN-SDM分数,较高的分数表明更大的SDM.
主要成果:
- 包括26名患有无并发性胆结石疾病的患者;68%是女性,平均年龄为47.8岁.
- 总体平均MAPPIN-SDM得分为2.6;患者 (3.5) 和外科医生 (2.9) 报告的SDM高于观察者 (1.55;p < 0.001).
- 接受手术的患者 (54%) 的SDM得分 (2.89) 比保守管理的患者 (2.28;p < 0.001) 高得多.
结论:
- 在不复杂的胆结石疾病咨询中存在中等水平的SDM.
- 在患者/外科医生的看法和观察者对SDM的评估之间发现了显著的差异.
- 更高的SDM与手术治疗选择有关,强调需要策略来提高SDM质量和一致性.
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