Shared Decision Making und Patientenzentrierung - vom Paternalismus zur Partnerschaft in der Medizin

Zusammenfassung

Im ersten Teil dieser zweiteiligen Serie wurde das Shared-Decision-Making-Modell als das am weitesten entwickelte Patienten-zentrierte Modell der Arzt-Patient-Kommunikation in Zusammenschau mit dem Paternalistischen Modell und dem Informativen Modell beschrieben. Ärzte äußern sich bislang eher zurückhaltend zum Shared Decision Making (SDM); selbst die Befürworter unter ihnen fühlen sich noch nicht ausreichend darauf vorbereitet, Patienten systematisch in die Entscheidungen einzubeziehen. Dagegen steht der starke Wunsch der Patienten nach umfassenden Informationen und Beteiligung an Behandlungsentscheidungen. Im zweiten Teil geht es um die Bedeutung der Risikokommunikation für die Darstellung von Behandlungsoptionen, um die Gefährdung der Wissensbasis der Medizin durch Interessen-geleitete Forschung und abschließend um die Auswirkungen von SDM auf die Behandlungswahl und auf die Behandlungsergebnisse.

Abstract

In the first part of this two-parts series the concept of shared decision making was described as the most advenced of the patient-centred concepts of physician-patient-communication. Physicians' attitudes tend to be somewhat reticent thoug; even those physicians who support patient involvement do not feel sufficiently prepared to fulfil the new role that the concept assigns to them. In the second part the relevance of risk communication for the explanation of the pros and cons of the treatment options is highlighted as well as the erosion of the medical knowledge base through industry-dominated knowledge production and the impact of shared decision making on the treatment choices and treatment results.

Schlüsselwörter

Shared Decision Making - Patientenbeteiligung - Patientenzentrierung - Arzt-Patienten-Beziehung - Entscheidungsfindung - Risikokommunikation - Interessenkonflikt

Key words

shared decision making - patient involvement - patient-centred medicine - doctor-patient-relationship - clinical decision making - risk communication - conflict of interest

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