臨床實(shí)踐中的患者價(jià)值觀(中英對(duì)照)

1、The values of patients in clinical practiceThe main contentThe main contentpatient values and preferencesAdjust the treatment Patient participation in decision-making model what are the important challenges of evidence-based medicine ? Atrial fibrillation patients facing the risk of stroke: The poss

2、ibility of taking warfarin for stroke in second years from 2% to 1%,but the risk of taking medication, doing blood tests, making activity limited, mild bleeding, or a large number of gastrointestinal bleeding may increase by 1% .二、為什么存在患者價(jià)值觀與意愿二、為什么存在患者價(jià)值觀與意愿Why patient values and preferences exist

3、二、為什么存在患者價(jià)值觀與意愿二、為什么存在患者價(jià)值觀與意愿 【關(guān)注價(jià)值觀及意愿的效益關(guān)注價(jià)值觀及意愿的效益】【Pay attention to patient values and the benefit of preferences】V V幫助患者選擇最佳治療方案，提高患者治療幫助患者選擇最佳治療方案，提高患者治療依從性依從性； Help patients to choose the best treatment, improve patient compliance ； V V緩解醫(yī)患關(guān)系，構(gòu)建和諧診療環(huán)境。緩解醫(yī)患關(guān)系，構(gòu)建和諧診療環(huán)境。 Alleviate the doctor-pa

4、tient relationship, build a harmonious medical environment三、認(rèn)識(shí)醫(yī)生患者價(jià)值觀的差異三、認(rèn)識(shí)醫(yī)生患者價(jià)值觀的差異Know the difference between the doctor Know the difference between the doctor values and values and patient valuespatient values三、認(rèn)識(shí)醫(yī)生患者價(jià)值觀的差異三、認(rèn)識(shí)醫(yī)生患者價(jià)值觀的差異Know the difference between the doctor Know the difference

5、 between the doctor values and values and patient valuespatient values四、正確引導(dǎo)患者價(jià)值觀四、正確引導(dǎo)患者價(jià)值觀Correctly guide the patient values四、正確引導(dǎo)患者價(jià)值觀四、正確引導(dǎo)患者價(jià)值觀 五、家庭與患者自主價(jià)值觀五、家庭與患者自主價(jià)值觀The independent values of family and patients五、家庭與患者自主價(jià)值觀五、家庭與患者自主價(jià)值觀Compulsory treatment of severe infectious patients and ser

6、iously affect the social order of the mental patients. 臨床醫(yī)生循證實(shí)踐必須考慮的問(wèn)題臨床醫(yī)生循證實(shí)踐必須考慮的問(wèn)題Clinicians must consider the question of eidence-based practiceClinicians must consider the question of eidence-based practice最佳證據(jù)是否適用于個(gè)體患者?研究結(jié)果用于患者時(shí)如何把握好尺度?如果某項(xiàng)亞組分析表面上非常適于患者，我應(yīng)該相信嗎? Is the best evidence available f

7、or 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? 臨床醫(yī)生循證實(shí)踐必須考慮的問(wèn)題臨床醫(yī)生循證實(shí)踐必須考慮的問(wèn)題Clinicians must consider the question of eidence-based practiceClinicians must consider the question of eidence-base

8、d practice基本了解患者病情后，如何制訂一個(gè)科學(xué)的治療方案?如何降低治療中的各種損傷和副作用?如果治療方案患者不接受，有無(wú)更好的替代方案?什么樣的治療方法最符合個(gè)體患者特定的價(jià)值觀和意愿?如何幫助患者參與治療決策?4. Basic understanding of the patients 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

9、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?你將如何解決你將如何解決? ?How will you solve it?How will you solve it?【病例病例】 一位一位5151歲的男性因胸痛找醫(yī)生看病。他過(guò)去一向身體歲的男性因

10、胸痛找醫(yī)生看病。他過(guò)去一向身體健康，但兩周前步行上山，發(fā)現(xiàn)健康，但兩周前步行上山，發(fā)現(xiàn)胸骨下有緊壓感胸骨下有緊壓感，休息休息2 2、3min3min后癥狀即消失后癥狀即消失。此后運(yùn)動(dòng)或休息時(shí)又發(fā)生過(guò)幾次類(lèi)似情。此后運(yùn)動(dòng)或休息時(shí)又發(fā)生過(guò)幾次類(lèi)似情況。他每天吸煙一包。況。他每天吸煙一包。血壓有點(diǎn)高血壓有點(diǎn)高，未服什么藥。他擔(dān)心自，未服什么藥。他擔(dān)心自己的健康，特別怕得心臟病。己的健康，特別怕得心臟病。A 51 year old man with chest pain to see a doctor He used to be in good health, but walk up the hill

11、 two weeks ago, found that there is a sense of tension under the chest, rest 2, 3min after the symptoms disappear. Several similar cases have occurred since the movement or rest. He smokes a packet of cigarettes a day. The blood pressure is a little high, not taking any drugs. He was worried about his health, especially for heart disease.你將如何