颌面部整形美容手术医患共享决策的研究进展  

Research progress on shared decision making in maxillofacial plastic surgery and aesthetic surgery

作　　者：罗淞元 王璧霞[1] 王旭东[1] LUO Songyuan;WANG Bixia;WANG Xudong(Department of Oral and Craniomaxillofacial Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《口腔疾病防治》2021年第10期701-705,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(8207030307);上海交通大学医学院“双百人”计划(20152225);上海市申康医院发展中心临床科技创新(新兴前沿)项目(SHDC12019103);上海市卫生计生委智慧医疗专项研究项目(2018ZHYL0208);上海交通大学医学院附属第九人民医院护理院级基金项目(JYHL2021MS03);上海交通大学医学院附属第九人民医院“优秀护理人才计划”项目(JYHRC8⁃P06)。

摘　　要：共享决策(shared decisionmaking,SDM)是指医患双方基于现有的循证医学证据以及患者的偏好双向沟通,决定最适合患者的治疗计划。规范的SDM实施方法有助于医患SDM有效进行,如合适的语言引导、使用图表工具和患者辅助决策工具。颌面部美学不仅具有个性化和自主性特征,颌面部整形美容手术也具有多种治疗方案,导致患者在治疗决策时面临困扰。因此,有效实施颌面部整形美容治疗的医患SDM不仅有助于改善患者的治疗结局,满足患者个性化需求,还有助于提高医疗服务质量,提升整形美容患者满意度,减少医患矛盾。目前,SDM理论尚未引入国内颌面整形美容的临床实践中,其发展面临较多的困难,例如决策辅助工具的缺乏、诊疗时间有限以及医患沟通不足等问题,因此,研究与开发规范的SDM临床实施路径指南和决策辅助工具有利于SDM在国内颌面整形美容领域的应用与发展。Shared decision making(SDM)refers to two-way communication between doctors and patients.SDM helps surgeons decide the most suitable treatment plan for patients based on the medical evidence and the preferences of patients.A standardized clinical process and decision assistant tools,such as verbal tools,graphic tools,and patient decision aids,can help the shared decision-making work effectively.Since the sense of facial aesthetics is individual and there are multiple treatment options in plastic surgery,facial aesthetic surgery is suitable for the application of SDM.In addition,medical service centers can also meet the personalized needs of patients,provide high-quality medical services for patients and achieve better treatment results with SDM.SDM has not been introduced into the clinical practice of maxillofacial plastic surgery in China,and its development is facing many difficulties,such as the lack of decision aid tools,the limited time of diagnosis,and the lack of doctor-patient communication.Research and development of standard SDM clinical implementation path guides and decision aid tools will be beneficial to the application and development of SDM in the field of maxillofacial plastic surgery in China.

关 键 词：共享决策 医患沟通 决策辅助工具 颌面整形美容手术 美容手术 正颌手术 错[牙合]畸形 美学 

分 类 号：R782.2[医药卫生—口腔医学]