Shared decision-making in vascular surgery

被引:23
|
作者
Xu, Jun [1 ]
Prince, Anya E. R. [2 ]
机构
[1] Univ Iowa Hosp & Clin, Dept Surg, Div Vasc Surg, 200 Hawkins Dr,1524 JCP, Iowa City, IA 52242 USA
[2] Univ Iowa, Coll Law, Iowa City, IA 52242 USA
关键词
Shared decision-making; Bioethics; Decision aids; Patient values; Three-talk model; INVOLVEMENT; BARRIERS; WOMEN; AIDS;
D O I
10.1016/j.jvs.2019.03.002
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Ideally, patients' decision-making regarding surgical options should reflect myriad implicit values. The informed consent process is meant to ensure that patients' values mirror clinical decisions regarding expectations for outcomes, such as quality of life, life expectancy, and subsequent pain and suffering. However, surgeons are not always equipped to discuss patients' values. Methods: Shared decision-making is amethod that could help surgeons elicit patients' values and subsequently improve the patient's knowledge and satisfaction, among other important outcomes. Yet, several barriers hinder implementation of shared decision-making in the clinic, such as time, interpersonal characteristics, and trust. To address concerns, several tools and approaches have been developed to increase shared decision-making in the clinic. This article highlights two strategies: the three-talk model and decision aids. Conclusions: Shared decision-making is a tool that could be especially valuable in discussions regarding elective surgery. Further research is needed to determine how best to implement shared decision-making in the surgical setting. Without full integration of patients' values into discussions of surgical options, there will continue to be a disconnect between the surgical procedures, outcomes, and patients' values.
引用
收藏
页码:1711 / 1715
页数:5
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