摘要
癌症的治疗理念和技术发展到微创和精准医学新时代,但临床决策更加复杂化。临床决策是癌症诊疗中重要环节,但传统临床决策模式无法满足癌症患者对高质量诊疗日益增长的需求,而建立在叙事医学基础上的医患共同决策是理想的决策模式。叙事医学让外科医生关注患者的故事、重现真实世界及真实需求等,构建医患信任的合作关系,让医学人文渗透到癌症外科临床决策的全过程。叙事医学融入癌症的临床诊疗过程中,有助于突破医患共同决策困境,实现叙事赋能、赋权,达成基于叙事医学的医患共同决策,但是当前仍需提升外科医生的叙事医学能力和素养,加强叙事医学本土化实践,营造优质叙事医学生态。
Treatments and techniques of cancer are developing into the new era of minimally invasive therapy and precision medicine,but clinical decision-making is more complex.Clinical decision-making is an important component of clinical practices of cancer,but traditional models may not fully meet rising demands for high-quality care from cancer patients.The shared decision-making based on narrative medicine is an ideal approach.Narrative medicine allows surgeons to focus on the story of patients,understand the real-world and genuine needs,and build a trusting collaborative relationship between physicians and patients,thus integrating medical humanities into the entire process of clinical decision-making in oncologic surgery.Integrating narrative medicine into the clinical diagnosis and treatment of cancer helps overcome the challenges of shared decision-making between physicians and patients,empowering them with narratives and achieving shared decision-making based on narrative medicine principles.However,there is still a need to enhance surgeons'skills and literacy in narrative medicine,strengthen localized narrative medicine practices,and create a high-quality narrative medicine ecosystem.
作者
张志强
杨琳琳
刘志奇
于德新
ZHANG Zhiqiang;YANG Linlin;LIU Zhiqi;YU Dexin(Department of Urology,Second Affiliated Hospital of Anhui Medical University,Hefei 230032,China;Department of General Practice,Second People's Hospital of Hefei City,Hefei 230061,China)
出处
《医学与哲学》
北大核心
2024年第12期49-53,65,共6页
Medicine and Philosophy
基金
2019年全国医学专业学位研究生教育指导委员会(中国学位与研究生教育学会医学专业工作委员会)课题(A1-YX20190603-01)
2022年安徽省新时代育人质量工程项目(研究生教育)(2022jyjxggyj208)。
关键词
临床决策
医患共同决策
叙事医学
癌症
肿瘤外科
clinical decision-making
shared decision-making
narrative medicine
cancer
oncologic surgery
作者简介
共同第一作者:张志强(1984-),男,博士,副主任医师,研究方向:泌尿外科学、医学教育管理、叙事医学。E-mail:zhangzq_urology@126.com;共同第一作者:杨琳琳(1985-),女,博士,副主任医师,研究方向:全科医学、叙事医学。E-mail:yanglinlin0308@sina.com。
