摘要
醫療決策的品質攸關整體醫療品質和病人的福祉，目前臨床最常見有三種醫療決策模式：（1）父權決策模式，（2）告知決策模式，（3）共同決策模式，其中共同決策模式最能夠凸顯以病人為中心照護之精神。我們先就父權決策模式和告知決策模式，做一個概括性的論述，再深入探討共同決策模式，就其定義、臨床應用、臨床試驗是否適合或必須適用和其執行障礙等面相加以探討。依其定義而言我們主要採用Charles C等學者之定義並增添一項病患在參與共同決策模式時，於資訊交換該階段，和醫師一樣，可提出對醫療計畫之建議。希望本篇文章有助於共同決策模式之推廣，進而提升醫療品質，造福病患，將以病患為中心的照護精神發揚光大。
並列摘要
The quality of medical decision-making affects both quality of medical care and welfare of patients. Paternalistic, informed and shared decision-making models are three of the most adopted medical decision-making models. Among them, the shared decisionmaking model can best reflect the essence of patient-centered care. We first made a general description of paternalistic and informed decision-making. Then detailed descriptions of the definition, applications in clinical trials and obstacles of the shared decision-making were presented. In addition to the definition of Charles C and et al., we added that patients, as doctors, can present medical care options during the stage of information exchange while participating in shared decision-making. The purpose of this study is to promote the application of shared decision-making, improve the quality of medical care, benefit patients' overall medical experience and highlight the importance of patient-centered care.
被引用紀錄
延伸閱讀
- 李思潔、周昱辰、蔡甫昌（2022）。醫病共享決策與臨床倫理。台灣醫學，26(1)，84-89。https://doi.org/10.6320/FJM.202201_26(1).0011
- 李婉菱、張慈惠、黃嗣棻（2021）。醫病共享決策之概念與實務。台大護理雜誌，17(1)，5-13。https://doi.org/10.6740/NTUHJN.202101_17(1).0002
- 陳尹甄、鍾侑倫、林思妤（2022）。醫病共同決策於產科照護之推動與落實。台灣實證醫學學會會刊，13(2)，13-15。https://doi.org/10.6864/EC.202212_13(2).0005
- 黃怡詔（2007）。建構決策資訊系統及其在醫療服務工程之實證研究〔博士論文，國立清華大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0016-1206200714114222
- 譚家偉、陳可欣、張秀如、黃珮玲、鄭思敏、李佳穗、陳作孝、劉秋芬、周昀昀、薛曉筑、李惠蘭、賈淑麗、王英偉（2020）。Value of Shared Decision Making from Patients' Perspective。醫療品質雜誌，14(1)，36-41。https://doi.org/10.3966/199457952020011401008