摘要
帕金森病无法治愈,病程难以预测,其治疗手段多样且因病程而异,应尽早规范诊疗以最大限度延缓疾病进展,而患者早期因信息支持不足、健康素养低、担忧特异性症状对日常生活和工作的影响等更增加了决策难度,诸多治疗决策难题将阻碍患者康复诊疗进程。共享决策是基于患者偏好与价值取向,结合医护人员提供的涵盖不同利弊因素的信息支持,经过医患双方沟通、反思最终达成最佳治疗决策的过程。共享决策注重“以患者为中心”,有利于降低患者决策冲突与决策后悔、提高决策满意度、改善治疗依从性和康复结局。近年国外研究表明帕金森病患者治疗决策参与意愿强,共享决策的应用体系相对完善,而国内对帕金森病患者共享决策应用关注较少。本文综述了共享决策在帕金森病患者中的应用现状,分析了共享决策在帕金森病患者应用中的阻碍因素,包括患者及照顾者、医护人员和医疗卫生资源与政策等层面,并提出在中国帕金森病患者中开展共享决策的相关建议,以期为推动共享决策在帕金森病患者治疗领域的研究提供参考。
Parkinson’s disease is incurable,the course of the disease is unpredictable,and its treatment methods are diverse and different according to the course of the disease,so the diagnosis and treatment should be standardized as soon as possible to delay the progression of the disease to the greatest extent.Shared decision-making is based on the patient’s preference and value orientation,combined with the information support provided by the medical staff covering different pros and cons,and finally reaches the best treatment decision through communication and reflection between the doctor and the patient.Shared decision-making focuses on“patient-centeredness”,which is conducive to reducing patients’decision-making conflict and decision-making regret,improving decision-making satisfaction,and improving treatment compliance and rehabilitation outcomes.In recent years,foreign studies have shown that patients with Parkinson’s disease have a strong willingness to participate in treatment decision-making,and the application system of shared decision-making is relatively perfect,while less attention has been paid to the application of shared decision-making for patients with Parkinson’s disease in China.This article reviews the application status of shared decision-making in patients with Parkinson’s disease,analyzes the obstacles to the application of shared decision-making in patients with Parkinson’s disease,including patients and caregivers,medical staff,medical resources and policies,and puts forward relevant suggestions for sharing decision-making in patients with Parkinson’s disease in China,in order to provide reference for promoting the research of shared decision-making in the treatment of patients with Parkinson’s disease.
作者
郎艳茹
梁战华
尹安春
LANG Yanru;LIANG Zhanhua;YIN Anchun(The First Affiliated Hospital of Dalian Medical University,Dalian 116000,China)
出处
《中国实用神经疾病杂志》
2025年第10期1315-1320,共6页
Chinese Journal of Practical Nervous Diseases
基金
辽宁省科学技术计划项目(编号:2013225002)
辽宁经济社会发展立项课题(编号:2015lslktzijjx-13)。
关键词
帕金森病
共享决策
应用现状
决策辅助工具
影响因素
干预模型
Parkinson’s disease
Shared decision-making
Application status
Decision-making aids
Influencing factors
Intervention model
