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白內障治療之醫病共享決策

Shared Decision Making for the Management of Cataract

摘要


醫病共享決策,是一種由醫師和病患共同參與醫療決策的過程。醫師向病患提供關於疾病的基本知識,解釋目前病況,提供治療選項,及各種選擇的優缺點。而病患也需要提出自己的想法,以及對於治療的期待與偏好,以此種雙向溝通,幫助醫病達成共識。本文介紹醫病共享決策在眼科白內障的應用,白內障是眼科門診很常見的疾病,目前手術仍為根治疾病的最好治療方式,但手術的時機與治療的細節仍有許多討論的空間。文章中提供病患白內障的相關基本知識,手術與其他治療選項,及其相應的好處與風險,並提示病患與眼科醫師溝通的重點,包括目前白內障的嚴重程度,開刀的時機與急迫性,開刀的風險,人工水晶體種類與度數與術後照護。

並列摘要


Shared decision making is a process that doctors and patients work together to make decisions regarding the treatment plan of certain disease. Doctors should convey the basic knowledge of the disease to the patients, explain the current status and severity of disease, and also provide the options of treatment and the pros and cons to the patients. The patients also need to clarify their opinions, expectations, and preference about the management. Shared decision making aims to help the doctors and patients to achieve the consensus about the management of disease. Cataract is a very common disease in eye clinic. Currently, surgery is still the best curative treatment for cataract. However, there is still room for discussion regarding the timing for surgery. This article made a brief introduction of cataract, including the basic knowledge, nonsurgical treatment options, surgery, and their pros and cons, and highlighted major points that patients should communicate with their ophthalmologists before making decisions, including the current disease severity, timing for cataract surgery, pros and cons for cataract surgery, the choice of intraocular lens, and post-operative cares.

並列關鍵字

cataract shared decision making

參考文獻


Song P, Wang H, Theodoratou E, et al. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 2018;8:010804.
Flaxman SR, Bourne RRA, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health 2017;5:e1221-34.
Gray CS, Karimova G, Hildreth AJ, et al. Recovery of visual and functional disability following cataract surgery in older people: Sunderland Cataract Study. J Cataract Refract Surg 2006;32:60-6.
Ishii K, Kabata T, Oshika T. The impact of cataract surgery on cognitive impairment and depressive mental status in elderly patients. Am J Ophthalmol 2008;146:404-9.
Garg P, Roy A, Sharma S. Endophthalmitis after cataract surgery: epidemiology, risk factors, and evidence on protection. Curr Opin Ophthalmol 2017;28:67-72.

延伸閱讀


  • 江宜靜、王守玉(2020)。白內障完整評估治療與照護趨勢護理雜誌67(2),84-90。https://doi.org/10.6224/JN.202004_67(2).11
  • 王怡珺(2000)。白內障預防之天然物研究〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714450520
  • 楊榮森、楊宗翰(2021)。手術之醫病共享決策台灣醫學25(1),111-117。https://doi.org/10.6320/FJM.202101_25(1).0011
  • 劉又綾(2016)。白內障年齡下降,治療有良方彰基院訊33(7),10-11。https://www.airitilibrary.com/Article/Detail?DocID=P20140814001-201607-201608090013-201608090013-10-11
  • 行政院衛生署全民健康保險爭議審議委員會(2004)。Cataract Surgery Treatment台灣醫學8(3),382-383。https://doi.org/10.6320/FJM.2004.8(3).13