癌症患者安宁疗护服务共同决策理论框架和辅助工具研究进展
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1.南京医科大学医政学院;2.南京医科大学数智技术与健康治理实验室;3.南京医科大学医政学院;4.上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所);5.南京市浦口人民医院;6.浙江大学医学院附属妇产科医院

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教育部“春晖计划”合作科研项目(编号:HZKY20220177)。“国家卫生健康委员会卫生技术评估重点实验室(复旦大学)”开放基金课题(编号:FHTA2023-08)。上海市卫生健康委员会卫生行业临床研究专项(编号:202140314)。教育部人文社会科学研究青年项目(编号:23YJCZH114)。国家自然科学基金面上项目(编号:72174093,72474109)


Progress on the theoretical framework and patient decision aids of shared decision making in hospice care for cancer patients
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1.School of Health Policy and Management, Nanjing Medical University;2.Shanghai Health Development Research Center (Shanghai Medical Information Center);3.Pukou Renmin Hospital;4.1.School of Health Policy and Management, Nanjing Medical University;5.2.Laboratory for Digital Intelligence &6.Health Governance, Nanjing Medical University

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    摘要:

    如何通过共同决策推动终末期癌症患者安宁疗护服务利用、实现“善终”已成为亟待解决的现实问题。本文首先对国内外癌症患者共同决策的理论框架、辅助工具及其在安宁疗护服务中的实施现状进行了文献综述。其次,基于实施性研究综合框架识别了癌症患者安宁疗护服务共同决策辅助工具实施的障碍性因素。最后,提出了共同决策驱动癌症患者安宁疗护服务利用的干预策略,具体包括:①开发适应国情的癌症患者安宁疗护服务共同决策辅助工具;②通过社会规范构建和跨学科合作、改善共同决策的内外部环境;③基于患方需要评估和服务方持续培训消除个体层面障碍性因素;④通过监测和评估辅助工具应用效果、持续改进和优化共同决策实施过程。

    Abstract:

    Abstract: How to promote the utilization of hospice care and achieve the goal of "good death" for terminal cancer patients through shared decision making has become a pressing practical issue. This article provides a review on the theoretical framework, patient decision aids and current implementation statues of shared decision making for cancer patients both domestically and internationally, particularly within the context of hospice care. We then identified the barriers based on the Consolidated Framework for Implementation Research. Finally, we proposed intervention strategies driven by shared decision making to enhance the hospice care use by cancer patients, including: 1) developing patient decision aids for hospice care among cancer patients adapted to local context; 2) enhancing the internal and external environments for shared decision making through the establishment of social norms and interdisciplinary collaboration; 3) addressing individual-level barriers based on patient needs assessment and continuous training for service providers; 4) monitoring and evaluating the effectiveness of patients-aid tools, with the aim of continuously improving and optimizing the shared decision making.

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  • 收稿日期:2024-09-06
  • 最后修改日期:2024-11-14
  • 录用日期:2024-11-20
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