末期攝護腺癌之醫病共享決策

Shared Decision Making for Terminal Prostate Cancer

謝淑華(Su-Hua Hsieh) ； 林秀櫻(Hsiu-Ying Lin) ； 黃國皓(Kuo-How Huang)

《台灣醫學》 25卷2期 (2021/03) Pp. 244-249

https://doi.org/10.6320/FJM.202103_25(2).0010

摘要

醫病共享決策（shared decision making, SDM）是病患與醫師共同參與醫療決策的過程。醫療人員在有限的門診時間，要協助病人做出最合適的醫療決策，對醫療人員是一個很大的挑戰。SDM已經應用在許多醫療領域。此篇文章討論醫病共享決策模式在泌尿科領域的運用。其中，癌症是威脅生命的重大疾病，隨著醫療進步，癌症有更多種治療方式，需考量層面很多，更是困難耗時的決策過程。本文將以轉移性前列腺癌為例，討論應用醫病共享決策的應用，如何使得醫病溝通更有效率，也探討各種主觀和客觀的限制，及未來的發展。

關鍵字

醫病共享決策 ； 泌尿科 ； 前列腺癌 ； 溝通

並列摘要

Shared decision making (SDM) is a collaborative approach in medical care that improves the quality of medical decisions by helping patients choose options concordant with personal values and in accordance with best practice of scientific evidence. The increasing focus on patient-centered care has made SDM adopted more and more common in in recent years. With the progress in prostate cancer therapies, patients with metastatic prostate cancer presented the benefits and harms of different health care choices. In this review, we will discuss the application of SDM in metastatic prostate cancer and how is SDM capable of coming to shared decision making in clinical practice. The review will also discuss the limitations and prospective development of SDM in the urological field.

並列關鍵字

shared decision making ； urology ； prostate cancer ； communication

參考文獻

張珏、張菊惠、胡幼慧：某醫學中心子宮切除婦女自述醫病溝通探討。中華公共衛生雜誌 1997;16:1-12。

郭怡良：醫病共享決策於物理治療專業之臨床應用現況物理治療。物理治療 2018;43:24-31。

Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med 1997;44:681-92.

Chiou CP, Chung YC. Effectiveness of multimedia interactive patient education on knowledge, uncertainty and decision-making in patients with end-stage renal disease. J Clin Nurs 2011;21:1223-31.

Tsai DFC. The bioethical principles and Confucius' moral philosophy. J Med Ethics 2005;31:159-63.