共享決策在產科臨床上的應用

Application of Shared Decision-Making in Maternal Care

陳淑溫(Shu-Wen Chen)

《台灣醫學》 22卷5期 (2018/09) Pp. 560-566

https://doi.org/10.6320/FJM.201809_22(5).0012

摘要

產科是醫療糾紛發生頻率極高的科別，為了避免醫療糾紛，醫師不願提供婦女更多元的生產選擇。共享決策（sharing decision-making，SDM）是以病人為中心的照護模式，支持病人做各種健康的選擇，是兼具知識，溝通和尊重三元素的最佳照護模式。經由共享決策（SDM）照護模式，不僅可以改善產科緊張的醫病關係，也可以提供孕婦較滿意且高品質的照護。

關鍵字

共享決策 ； 決策輔助 ； 產科

並列摘要

Obstetrics accounts for a large proportion of medical disputes. To avoid medical disputes, obstetricians are reluctant to provide women with various birth choices. Sharing decision-making (SDM) is a model of patient-centred care that helps patients to make various health choices. SDM is an effective care model that combines knowledge, communication, and respect. The SDM model can improve the relationship between doctors and patients and provide pregnant women with satisfactory and high-quality care.

並列關鍵字

shared decision-making ； decision aids ； obstetrics

參考文獻

陳淑溫、鄭博仁：初次剖腹產後的生產方式：臺灣產科醫生的決策策略。助產雜誌 2015;57:55-69.[ Chen SW, Cheng, PJ: Mode of birth following a primary caesarean section: Taiwanese obstetricians'decision-making strategies. The Journal of Midwifery 2015;57:55-69.]"

陳淑溫：台灣重複剖腹產婦女的決策過程。護理雜誌 2016;63:44-54.[Chen SW: The decision-making processes in Taiwanese women with repeat caesarean deliveries. The Journal of Nursing 2016;63:44-54.]"

Hamasaki T, Hagihara A: A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments. BMC Medical Ethics 2015;16:72."

Schleiter KE: Difficult patient-physician relationships and the risk of medical malpractice litigation. Virtual Mentor 2009;11:242-6."

Moudi Z, Phanodi Z, Ansari H, et al: Decisional conflict and regret: shared decision-making about pregnancy affected by β-thalassemia major in Southeast of Iran. Journal of Human Genetics 2018;63:309."