病人参与临床决策现状调查与分析.pdfVIP

Original Articles Chin J Evid-based Med 2010, 10(1): 10-13 病人参与临床决策现状调查与分析 1,# 1,# 1 1 1 1 1 张琼文   万晓莉   刘  颖  董欣欣  王海清  王  飞  周  洋  范志宇1 1 2,*   陈熹阳  张鸣明   1. 四川大学华西临床医学院（成都 610041 ）；2. 四川大学华西医院中国循证医学中心（成都 610041 ） 摘要  目的 探讨影响医患共享临床决策的因素，为医患共享临床决策提供思路与对策。方法 随意抽取 四川省某三甲医院的患者，以匿名问卷，采取调查员指导下被调查者自填调查表的方式对患者进行问卷调查。用 Excel 建立数据库，采用SPSS 13.0 进行统计分析。结果 共发放调查问卷600 份，实际收回有效问卷565 份，有效 回收率94%。调查结果显示：68% 的患者对所患疾病的相关信息有一定了解；93% 的患者愿意积极参与临床决策； 患者在就医过程中最担心的问题依次为治疗措施的疗效、费用和医生技术；患者就医的最大困难为门诊等待时间 长和与医生交流时间短。结论 针对患者有参与临床决策的积极愿望但又存在知识局限性的现状，加之医疗服务 的多维性和医学科学的不确定性等医疗或非医疗因素，临床医生有必要为患者提供多种选择，帮助患者寻找足够 的相关信息，共同分析，提高患者的满意度。 关键词 患者参与；共享决策；医患关系 A Survey Analysis of Patients’ Perceptions of Difficulties in Shared Clinical Decision-Making 1,# 1,# 1 1 1 1 ZHANG Qiong-wen , WAN Xiao-li , LIU Yin , DONG Xin-xin , WANG Hai-qing , WANG Fei , 1 1 2,* FAN Zhi-yu , CHEN Xi-yang , ZHANG Ming-ming 1. West China School of Medicine Sichuan University, Chengdu 610041, China; ， 2. Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu 610041, China Abstract Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 565 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous self- administered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. T