Patients' view
http://www.100md.com
《英国医生杂志》
Osteoarthritis is a painful chronic disease that will not get better, only worse. As two people with osteoarthritis in various joints, we know that it can affect your outlook on life as well as quality of life.
Despite her disease, Mrs Patell wants to enjoy her evening cocktail and dinner wine as well as help her husband around the house. She did not present to her doctor with a complaint of pain and an interest in other treatments—she is likely to have been informed of these previously and tried them. Rather, Mrs Patell presents with information she received from her friend about possible harms of treatment that could be caused by alcohol consumption.
We have worked through similar decision making experiences around numerous treatment options. Making informed decisions about treatments has become a complex chore. Like Mrs Patell, we receive information from friends or our children, spouses, and neighbours. The media is another whole ball of wax. New drugs are announced regularly on the television and radio, in newspapers and magazines, as well as on the internet.
We are faced with a lot of treatment choices, and healthcare providers have to deal with all the information that may relate to everything patients present with. Ideally, patients approach their physicians with their concerns and are given the best information physicians have at hand. But often patients are distracted by other questions they want to ask and do not always "hear" what is said. They may also forget to ask questions, only to think of them on their way home. Nervousness, shyness, or embarrassment from not understanding the information may lead people to say they understand when they do not. Having a research summary in a decision aid can help.
for Value patients
A decision aid is a good idea. It presents key research evidence concisely in a visual and narrative form that is easily understood and recognises different learning styles. We find the explanations much more meaningful than the "number needed to treat" concept. The decision aid helps to set the stage for further discussion of the various considerations and steps involved in the decision making process. It can be taken away and completed in the quiet of your home, when you feel mentally and emotionally ready to make a decision. You can then return to the physician better informed and with thought out questions, focusing a potentially unstructured conversation that occurs as part of other activities during the appointment.
One respondent on bmj.com questioned whether this tool was to "let the physician off the hook." On the contrary, we think it's important that the practitioner refer to the decision aid when speaking with the patient. Patients may want more information or want to clarify why the decision is important to make at this time. In the end, the information, values, and preferences have been analysed and discussed, truly opening the gate for communication between patients and practitioners. The use of decision aids allows people to make educated decisions about the most important thing in the world—their bodies.(Nancy Corbett, Diane Desc)
Despite her disease, Mrs Patell wants to enjoy her evening cocktail and dinner wine as well as help her husband around the house. She did not present to her doctor with a complaint of pain and an interest in other treatments—she is likely to have been informed of these previously and tried them. Rather, Mrs Patell presents with information she received from her friend about possible harms of treatment that could be caused by alcohol consumption.
We have worked through similar decision making experiences around numerous treatment options. Making informed decisions about treatments has become a complex chore. Like Mrs Patell, we receive information from friends or our children, spouses, and neighbours. The media is another whole ball of wax. New drugs are announced regularly on the television and radio, in newspapers and magazines, as well as on the internet.
We are faced with a lot of treatment choices, and healthcare providers have to deal with all the information that may relate to everything patients present with. Ideally, patients approach their physicians with their concerns and are given the best information physicians have at hand. But often patients are distracted by other questions they want to ask and do not always "hear" what is said. They may also forget to ask questions, only to think of them on their way home. Nervousness, shyness, or embarrassment from not understanding the information may lead people to say they understand when they do not. Having a research summary in a decision aid can help.
for Value patients
A decision aid is a good idea. It presents key research evidence concisely in a visual and narrative form that is easily understood and recognises different learning styles. We find the explanations much more meaningful than the "number needed to treat" concept. The decision aid helps to set the stage for further discussion of the various considerations and steps involved in the decision making process. It can be taken away and completed in the quiet of your home, when you feel mentally and emotionally ready to make a decision. You can then return to the physician better informed and with thought out questions, focusing a potentially unstructured conversation that occurs as part of other activities during the appointment.
One respondent on bmj.com questioned whether this tool was to "let the physician off the hook." On the contrary, we think it's important that the practitioner refer to the decision aid when speaking with the patient. Patients may want more information or want to clarify why the decision is important to make at this time. In the end, the information, values, and preferences have been analysed and discussed, truly opening the gate for communication between patients and practitioners. The use of decision aids allows people to make educated decisions about the most important thing in the world—their bodies.(Nancy Corbett, Diane Desc)