恶性肿瘤诊疗中实施医患共同决策的困境与前景  

Predicament and prospect of implementing shared decision making in the diagnosis and treatment of malignant tumors

作　　者：侯睿[1] HOU Rui(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing100730,China)

机构地区：[1]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《中国医药导报》2024年第19期62-66,共5页China Medical Herald

基　　金：北京协和医学院“中央高校基本科研业务费”项目(3332021016)。

摘　　要：近年来医患共同决策(SDM)理念逐渐兴起,越来越多的恶性肿瘤患者愿意积极参与临床决策,结合自身价值需求,同医师共同讨论、制订精准而个体化的诊疗方案。SDM模式不仅无损于治疗结局,还能提高患者满意度、治疗依从性、生活质量、心理状态、自我效能及更少的住院费用。然而囿于医患关系紧张,医生理念/知识更新缓慢、沟通能力欠缺,患者经济、社会背景差异及家属干预等多方面因素,SDM在中国面临诸多困境与挑战,在肿瘤患者诊疗中尚未广泛有效实施。In recent years,the concept of shared decision making(SDM)has gradually gained popularity,with an increasing number of patients with malignancy willing to actively participate in clinical decision making,to form precise and individualized treatment plans in line with their own values and needs.SDM model not only does not compromise treatment outcomes,but also achieves better patient satisfaction,treatment compliance,quality of life,psychological state,self-efficacy,and lower hospitalization costs.However,due to the tense doctor-patient relationship,slow updates of doctor concepts/knowledge,lack of communication skills,differences in patient economic and social backgrounds,and family intervention,among other factors,SDM faces many difficulties and challenges in China,and has not yet been widely and effectively implemented in the diagnosis and treatment of tumor patients.

关 键 词：恶性肿瘤 医患共同决策 手术 生活质量 

分 类 号：R730.5[医药卫生—肿瘤]