摘要
在当今医学领域,不确定性普遍而广泛存在于医疗保健系统。其可以出现在诊疗的各个环节,以各种形式,通过不同方式影响医生和患者,进而影响诊疗效果,是医疗服务过程中的极大挑战。达成面对医疗不确定性的共识,有利于建立持久的、以信赖为基础的医患关系,实现双方利益平衡。全科医生作为一般患者的首诊医生,面临着多样化疾病谱和患者个体差异等挑战,如何管理不确定性问题成为全科医生日常工作的一部分,掌握不确定性的管理策略对于全科医生显得尤为重要。然而,目前对医学不确定性的系统研究非常有限,国内大部分研究局限于不确定性在某项技术或某个过程中的应用,缺乏相关综合性论述,对不确定性管理策略的分析整合鲜少提及,为此笔者作了一项系统文献综述,以探索适用于全科医学的不确定性管理策略。本文从医学不确定性的来源和影响对其进行分析,进而对如何在临床决策中管理医学不确定性,在不确定性中制定适宜的临床决策进行讨论。笔者认为各种来源的医学不确定性会导致医患双方情绪、行为、反应的负面效应,通过采取合适的管理策略有可能减轻医学不确定性及其造成的影响,对不确定性背景下的临床决策有一定的参考意义。
Uncertainty is pervasive within the healthcare system in medical filed nowadays.It impacts all aspects of diagnosis and treatment,affecting doctors and patients in various ways.Establishing a consensus on medical uncertainty facilitates the establishment of enduring doctor-patient relationships based on trust balance the interests of both parties,thereby influencing the efficacy of diagnosis and treatment.This poses a significant challenge in medical services.As the initial clinicians for the patients,General Practitioners are faced with challenges of managing a wide range of diseases and accommodating individual patient differences.Effectively navigating uncertainty is an integral part of their daily responsibilities,making the mastery of uncertainty management strategies particularly crucial for general practitioners.However,the current research on medical uncertainty is severely limited,with most domestic studies focusing on the application of uncertainty in specific technologies or processes.Comprehensive discussions and analysis and integration of uncertainty management strategies are lacking.Therefore,we conducted a systematic literature review to explore applicable uncertainty management strategies in general practice.This article analyzes the origins and ramifications of medical uncertainty and explores approaches to manage it during clinical judgments.We posit that medical uncertainty from various sources can negatively affect the emotions,behaviors,and reactions of both healthcare professionals and patients.However,adopting appropriate management strategies can mitigate these effects,providing a reference for clinical decision-making under the background of uncertainty.
作者
高可音
史威力
王留义
GAO Keyin;SHI Weili;WANG Liuyi(Department of General Practice,People's Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)
出处
《中华全科医学》
2024年第8期1267-1271,共5页
Chinese Journal of General Practice
基金
河南省医学科技攻关计划软科学项目(RKX202101001)
郑州市科技计划项目(2021KJHM0022)。
关键词
医学不确定性
全科医生
管理策略
临床决策
Medical uncertainty
General practitioners
Management strategy
Decision-making
作者简介
通信作者:王留义,E-mail:wly2000@126.com。
