叙事医学融入外科临床决策的思考

Thinking on Narrative Medicine Integrating into Surgical Decision-making

临床决策是临床工作的重要环节,与医疗质量密切相关,但传统临床决策模式无法满足人们对高质量诊疗的需求,而建立在医患信任、信息共享基础上的医患共同决策是理想的决策模式。当前外科临床决策中医学人文理念不强,严重影响临床决策的质量。叙事医学让医生关注患者的故事、社会生活环境及需求等,有助于信息共享,建立医患信任的合作关系,让医学人文渗透到外科临床决策中,共同制定治疗方案。叙事医学的临床实践有助于解决医患共同决策困境,推进医患共同决策模式,但是仍需加强叙事医学本土化,提升医生的叙事医学素养。

Clinical decision-making is an important component of clinical practices. Nowadays, traditional decision-making can’t meet the rising demands for high-quality care in hospitals. The shared decision-making based on mutual trust and information sharing is an ideal communication model.Medical humanities are always absent in surgical decision-making, which severely impacts the quality of clinical decision-making.Narrative medicine facilitates doctors paying attention to the story of patients, living conditions, and personal needs. It is helpful to information sharing, a harmonious doctor-patient relationship with trust, natural integration of medical humanity into surgical decision-making, and shared-making therapeutic plan. The clinical practice of narrative medicine is helpful to resolve the dilemma of decision-making, but it also needs continuous localization and the promotion of narrative medical literacy.