糖尿病管理中共享决策应用的系统综述

汪 秋实¹, 李 芬²
1、苏州市相城区第二人民医院
2、通讯作者苏州市相城区第二人民医院

摘要

目的：共享决策（SDM，ShareDecisionMaking）是医患间通过信息沟通和分享，并以患者为中心考虑患者的价值观和偏好，交互协作参与治疗或管理方案制订的过程。该文介绍了糖尿病流行和共享决策的背景，指出了共享决策的实施意义，并详细介绍了其在糖尿病治疗管理中的应用情况。共享决策又基于决策辅助工具，即将患者引入决策参与过程中，提升其对决策中相关知识理解和自我效能等水平，从而选择更具有个体适应性的方案。

关键词

糖尿病管理；共享决策；决策辅助工具

参考

[1]Cho N H., Shaw J E, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045[J]. Diabetes Res Clin Pract, 2018,138:271-281.[2]Barcelo A, Gregg E W., Gerzoff R B., et al. Prevalence of diabetes and intermediate hyperglycemia among adults from the first multinational study of noncommunicable diseases in six Central American countries: the Central America Diabetes Initiative [J]. Diabetes Care, 2012,35(4):738-740.[3]Shen X, Vaidya A, Wu S, et al. THE DIABETES EPIDEMIC IN CHINA: AN INTEGRATED REVIEW OF NATIONAL SURVEYS[J]. Endocr Pract, 2016,22(9):1119-1129.[4]Hoffmann T C., Montori V M., Del Mar C. The connection between evidence-based medicine and shared decision making[J]. JAMA, 2014,312(13):1295-1296.[5]Barry M J., Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care[J]. N Engl J Med, 2012,366(9):780-781.[6]Glass K E., Wills C E, Holloman C, et al. Shared decision making and other variables as correlates of satisfaction with health care decisions in a United States national survey[J]. Patient Educ Couns, 2012,88(1):100-105.[7]Burton D, Blundell N, Jones M , et al. Shared decision-making in cardiology: do patients want it and do doctors provide it?[J].Patient Educ Couns, 2010,80(2):173-179.[8]侯晓婷,徐征,周玉洁,等.结直肠癌住院患者参与手术治疗决策的现况研究[J].中华护理杂志,2014,49(05):526-529.[9]傅文静,戴燕,李晓玲.126例门诊慢性伤口患者参与治疗决策的现状调查[J].护理学报,2017,24(18):44-47.[10]Wang M J., Hung L C, Lo Y T. Glycemic control in type 2 diabetes: role of health literacy and shared decision-making[J]. Patient Prefer Adherence, 2019,13:871-879.[11]Kunneman M, Branda M E., Ridgeway J L, et al. Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention[J]. Endocrine, 2022,75(2):377-391.[12]Stacey D, Legare F, Lewis K, et al. Decision aids for people facing health treatment or screening decisions[J]. Cochrane Database Syst Rev, 2017,4:D1431.[13]Bailey R A.,Pfeifer M,Shillington A C, et al. Effect of a patient decision aid (PDA) for type 2 diabetes on knowledge, decisional self-efficacy, and decisional conflict[J]. BMC Health Serv Res, 2016,16:10.[14]Mullan R J,Montori V M, Shah N D, et al. The diabetes mellitus medication choice decision aid: a randomized trial[J]. Arch Intern Med, 2009,169(17):1560-1568.[15]郭玉茹.单侧全膝关节置换恐动症患者功能锻炼决策辅助方案的构建与应用[D].郑州大学,2020.[16]Huang R, Song X, Wu J, et al. Assessing the feasibility and quality of shared decision making in China: evaluating a clinical encounter intervention for Chinese patients[J]. Patient Prefer Adherence, 2016,10:2341-2350.[17]苏清清,孟俊华,库洪安,等. 糖尿病自我管理决策辅助信息平台的构建与应用[J].解放军护理杂志,2021,38(04):13-16.