[诊断中的共享决策:实用指南]
Sofie Jacobse1,2, Hanneke Rijkels-Otters3, Laura Zwaan4
1Erasmus MC, Rotterdam. Afd. Huisartsgeneeskunde en Institute of Medical Education Research Rotterdam (iMERR).
Nederlands tijdschrift voor geneeskunde
|February 20, 2026
概括
共享决策 (SDM) 通过将患者价值观与临床专业知识相结合,增强诊断过程. 将SDM应用于诊断,特别是在不确定性和风险的领域,可以改善以患者为中心的护理并减少伤害.
科学领域:
- 医学伦理 医学伦理
- 一般的做法一般的做法
- 患者安全 患者安全
背景情况:
- 共享决策 (SDM) 在治疗和查方面已经建立,但在诊断方面未得到充分利用.
- 诊断决策涉及独特的挑战,如不确定性和不断变化的证据.
研究的目的:
- 在诊断过程中确定SDM可以增加价值的关键领域.
- 探索SDM在一般实践诊断决策中的相关性.
主要方法:
- 分析了90个匿名的医疗失误索赔,这些索赔与一般实践中的诊断决策有关.
- 确定患者和临床医生的观点分歧的主题.
主要成果:
- 六个主题出现了,SDM可以增加价值:风险评估,时间作为诊断工具,测试后果,实际执行,诊断再评估和个人背景.
- 在这些主题中,医生和患者之间存在不同的观点.
结论:
- 将SDM整合到诊断实践中可以改善相互理解和以患者为中心.
- 通过SDM解决已识别的主题可以防止延迟和减少诊断中的危害.
- SDM应该被认为是诊断护理的结构组成部分.
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