患者参与医疗决策相关概念框架辨析

Analysis of Conceptual Frameworks Related to Patient Engagement in Medical Decision-making

对患者参与医疗决策的相关核心概念进行了梳理,并对患者参与医疗决策与医患共同决策这两个概念进行了区分,可为国内学者开展相关研究提供概念指导。其次,对患者参与医疗决策的相关理论及概念框架进行了梳理,从适用范围及应用视角对医患共同决策理论、互动式决策框架、渥太华决策支持框架、Makoul模型、Three-Talk模型、Stiggelbout模型、跨专业共同决策模型、共同决策3圈模型进行了分析,其中医患共同决策理论、渥太华决策支持框架、Three-Talk模型已在国内得到应用,而与我国儒家文化提倡以家庭为中心的决策模式相适应的共同决策3圈模型仍未受到关注。

This paper reviewed the core concepts related to patient engagement in medical decision-making and distinguished the concepts between shared decision-making and patient-involved medical decision-making,which provided guidance on certain concepts for domestic scholars.Besides,this paper combed the theoretical and conceptual frameworks related to patient engagement in medical decision-making.From perspectives of application and its sphere,it preliminarily summarized the advantages and disadvantages of shared decision-making model,interactive decision-making framework,Ottawa decision support framework,Makoul model,Three-Talk model,Stiggelbout model,interdisciplinary shared decision-making model,shared decision-making 3 circle model.The shared decision-making model,Ottawa decision support framework and Three-Talk model have been applied in China,but the shared decision-making 3 circle model,which coincides with family-centered decision-making model advocated by Chinese Confucian culture,has not received much attention.