Page 64 - 南京医科大学社科版

南 第1期 总第126期
南京医科大学学报（社会科学版）京医科大学学报（社会科学版）
· 58 ·
Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2025年2月
Journal
Shared decision ⁃ making among colorectal cancer sur⁃ VACHE J A，et al. Decision making in the end⁃of⁃life
gery patients in China［J］. Support Care Cancer，2020， care of patients who are terminally ill with cancer ⁃ a
28（11）：5353-5361 qualitative descriptive study with a phenomenological
［39］FAN S Y，HSIEH J G. The experience of do⁃not⁃resusci⁃ approach from the experience of healthcare workers［J］.
tate orders and end⁃of⁃life care discussions among physi⁃ BMC Palliat Care，2021，20（1）：76
cians［J］. Int J Environ Res Public Health，2020，17 ［45］朱雅麟，石琳琳，杨冠楠，等. 癌症患者医患间临终沟通
（18）：6869 的研究进展［J］. 中国医学伦理学，2023，36（5）：548-555
［40］胡宗萍，吕登智，陈鑫，等. 安宁疗护医患共同决策的 ［46］BEAUSSANT Y，MATHIEU⁃NICOT F，PAZART L，et al.
临床实践及对策［C］. 中国老年学和老年医学学会. 新 Is shared decision⁃making vanishing at the end⁃of⁃life?
时代积极应对人口老龄化研究文集，2021：323-332 A descriptive and qualitative study of advanced cancer
［41］GEORGE N R，KRYWORUCHKO J，HUNOLD K M，et patients’ involvement in specific therapies decision ⁃
al. Shared decision making to support the provision of making［J］. BMC Palliat Care，2015，14：61
palliative and end⁃of⁃life care in the emergency depart⁃ ［47］ TAN A，MANCA D. Finding common ground to achieve
ment：a consensus statement and research agenda［J］. a“good death”：family physicians working with substi⁃
Acad Emerg Med，2016，23（12）：1394-1402 tute decision ⁃ makers of dying patients. A qualitative
［42］ROODBEEN R，VREKE A，BOLAND G，et al. Commu⁃ grounded theory study［J］. BMC Fam Pract，2013，14：14
nication and shared decision⁃making with patients with ［48］翁冰冰，陈文，蒋虹丽. 医患共同决策模型及实践应用
limited health literacy；helpful strategies，barriers and 进展［J］. 医学与哲学，2023，44（5）：21-25
suggestions for improvement reported by hospital⁃based ［49］林海洋，黎玉梅，郝燕萍. 照护目标沟通在癌症患者临
palliative care providers［J］. PLoS One，2020，15（6）： 床应用中的研究进展［J］. 医学与哲学，2023，44（14）：
e0234926 42-47
［43］EDWARDS M，HOLLAND⁃HART D，MANN M，et al. Un⁃ ［50］姜姗，李忠，路桂军，等. 安宁疗护与缓和医疗：相关概
derstanding how shared decision⁃making approaches and 念辨析、关键要素及实践应用［J］. 医学与哲学，2019，
patient aids influence patients with advanced cancer 40（2）：37-42
when deciding on palliative treatments and care：a real⁃ ［51］孙寒璞. 安宁疗护的立法基础与规制进路［J］. 南京医
ist review［J］. Health Expect，2023，26（6）：2109-2126 科大学学报（社会科学版），2024，24（2）：155-161
［44］LUNA ⁃ MEZA A，GODOY ⁃ CASASBUENAS N，CAL⁃ （本文编辑：姜 鑫）
Progress on the theoretical framework and patient decision aids for
shared decision⁃making in hospice care for cancer patients

1，2 1 1 3 4
LI Zhong ，JIN Yuxin ，SHEN Yunqi ，ZHU Lin ，LI Xinyi
1. School of Health Policy and Management，2. Laboratory of Digital Intelligence & Health Governance，Nanjing Medical University，
Nanjing 211166；3. Shanghai Health Development Research Center（Shanghai Medical Information Center），Shanghai 200040；
4. General Office of Party and Hospital Affairs，Women’s Hospital，Zhejiang University，School of Medicine，Hangzhou 310006，China
Abstract：The challenge of 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 that
needs to be addressed. This article provided a literature review on the theoretical framework，patient decision
aids，and current implementation status of shared ⁃ decision ⁃ making for cancer patients in hospice care both
domestically and internationally. We then identified 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 contexts；（2）enhancing the internal and external environments for shared
decision⁃making through the construction of social norms and interdisciplinary collaborations；（3）addressing
individual⁃level barriers based on patient needs assessment and continuous training of service providers；（4）
continuously improving and optimizing shared decision ⁃ making through monitoring and evaluating the
effectiveness of patient⁃aid tools.
Key words：cancer patients；hospice care；shared decision making；doctor⁃patient communication