我国临床实践中的医患共同决策流程设计和挑战

Process Design and Challenge of Shared Decision-making in Clinical Practice in China

目前,国内对医患共同决策的研究和实施尚缺乏基于临床实践的系统性研究和对实施流程的整体设计。结合我国医疗背景,重点阐述对医患共同决策的理解和认知差异;探讨在临床实践中建立一个与我国医疗背景相适应的医患共同决策基础流程的初步设想,并从设计原理、基本架构、关键因素、对医患双方的能力要求等方面进行论述。结合实际提出我国医疗背景下,医患共同决策在临床实践中所面临的六个方面的主要挑战。希望能为医患共同决策在我国的研究应用提供可借鉴的思路和想法,推动在临床实践中的进一步应用。

At present, the doctor-patient shared decision-making (SDM) in China is lack of systematic research based on clinical practice and overall design of implementation process. Based on the healthcare context in China, this paper focuses on the understanding and cognitive differences of SDM, explores the preliminary idea of establishing a basic process of SDM in clinical practice, and discusses the design principle, framework, key factors and the ability requirements of both doctors and patients. Meanwhile, this paper discusses the main challenges of SDM in clinical practice in China and provides the implications, so as to promote the further application of SDM in clinical practice.