临床实践中患者价值观-(中英对照).pptVIP

六、患者价值取向在临床决策中的限度 The limit of patient's value orientation in clinical decision making 1.患者自主权与社会利益冲突时，社会利益优先。 Patient autonomy and social conflict of interest, social interest is preferred. 2.患者的自我决定权和拒绝治疗权是知情同意的重要内容之一。Patients' self - Determination and the right to refuse treatment are one of the important contents of informed consent. 强制性收治烈性传染患者和严重影响社会秩序的精神病人。 Compulsory treatment of severe infectious patients and seriously affect the social order of the mental patients. 二、调整决策方案顺应个体患者 的价值观与意愿 Adjusting the decision making scheme to conform to the individual patient values and preferences 【循证决策的本质】 【The essence of the evidence-based decisions】 在当前可得到的最好同类证据指导下，达到高度个性化的科学决策。 Under the guidance of the best similar evidence currently available, to achieve highly personalized scientific decision-making. 临床医生循证实践必须考虑的问题Clinicians must consider the question of eidence-based practice 最佳证据是否适用于个体患者? 研究结果用于患者时如何把握好尺度? 如果某项亚组分析表面上非常适于患者，我应该相信吗? Is the best evidence available for individual patients? How to grasp the scale of the good results for patients? If a subgroup analysis is very suitable for patients, should I believe it? 临床医生循证实践必须考虑的问题Clinicians must consider the question of eidence-based practice 基本了解患者病情后，如何制订一个科学的治疗方案?如何降低治疗中的各种损伤和副作用? 如果治疗方案患者不接受，有无更好的替代方案? 什么样的治疗方法最符合个体患者特定的价值观和意愿? 如何帮助患者参与治疗决策? 4. Basic understanding of the patient's condition, how to develop a scientific treatment plan, how to reduce the treatment of various damage and side effects? 5. If treatment options are not acceptable, there is no better alternative? 6. What kind of treatment is most consistent with individual patient specific values and wishes? 7. How to help patients to participate in treatment decisions? 你将如何解决?How will you solve it? 【病例】 一位51岁的男性因胸痛找医生看病。他过去一向身体健康，但两周前步行上山，发现胸骨下有紧压感，休息2、3min后症状即消失。此后运动或休息时又发生过几次类似情况。他每天吸烟一包。血压有点高，未服什么药。他担心自己的健康，特别怕得心脏病。 A 51 year old man with chest pain to see a doctor He used to be in good health, but wal