患者参与医患共同决策的思考

Reflection on Patient Involvement in Shared Decision-Making

医患共同决策克服了传统医疗决策模式的固有弊端,实现了“家长式决策模式”与“知情式决策模式”的有机结合,有利于做出最适合患者的医疗决策。然而,部分患者盲从医者权威、缺乏必要医学知识以及医患互信基础薄弱等现实问题,制约了患者对医疗决策的参与,阻碍了医患共同决策的推进。作为医疗决策的主体,患者有效参与能够促成医患双方相互理解、促进医患决策落实、纠正医患决策失误。破解医患共同决策实践难题,要将提升患者参与能力置于首位,开展面向社会公众的医学常识教育、发挥社会支持系统的正向作用、培育医患互信的现实基础。

Shared decision-making(SDM)overcomes the inherent drawbacks of traditional medical decision-making mode by combining the"paternalistic decision-making mode"and"informed decision-making mode",and is conducive to making the most suitable medical decisions for patients.However,challenges such as blindly following the authority of doctors,lacking necessary medical knowledge,and weak foundation of doctor-patient mutual trust restrict patients'participation in medical decision-making and hinder the promotion of SDM.As the main body of medical decision-making,patients'active involvement can promote mutual understanding between doctors and patients,facilitate the implementation of medical decisions,and rectify decision-making errors.To address the challenges in SDM practice,it is necessary to prioritize enhancing patients'participation abilities by conducting medical literacy education for the public,leveraging the positive role of social support system,and fostering a solid foundation of doctor-patient mutual trust.