Shared decision making: Concepts, evidence, and practice.

Autor: Stiggelbout AM; Department of Medical Decision Making/Quality of Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.m.stiggelbout@lumc.nl., Pieterse AH; Department of Medical Decision Making/Quality of Care, Leiden University Medical Center, Leiden, The Netherlands., De Haes JC; Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2015 Oct; Vol. 98 (10), pp. 1172-9. Date of Electronic Publication: 2015 Jul 15.
DOI: 10.1016/j.pec.2015.06.022
Abstrakt: Objective: Shared decision-making (SDM) is advocated as the model for decision-making in preference-sensitive decisions. In this paper we sketch the history of the concept of SDM, evidence on the occurrence of the steps in daily practice, and provide a clinical audience with communication strategies to support the steps involved. Finally, we discuss ways to improve the implementation of SDM.
Results: The plea for SDM originated almost simultaneously in medical ethics and health services research. Four steps can be distinguished: (1) the professional informs the patient that a decision is to be made and that the patient's opinion is important; (2) the professional explains the options and their pros and cons; (3) the professional and the patient discuss the patient's preferences and the professional supports the patient in deliberation; (4) the professional and patient discuss the patient's wish to make the decision, they make or defer the decision, and discuss follow-up. In practice these steps are seen to occur to a limited extent.
Discussion: Knowledge and awareness among both professionals and patients as well as tools and skills training are needed for SDM to become widely implemented.
Practice Implications: Professionals may use the steps and accompanying communication strategies to implement SDM.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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