Effect of shared decision-making education on physicians' perceptions and practices of end-of-life care in Korea

被引：2

作者：

Yu, Byung Chul ^{[1
]}

Han, Miyeun ^{[2
]}

Ko, Gang-Jee ^{[3
]}

Yang, Jae Won ^{[4
]}

Kwon, Soon Hyo ^{[5
]}

Chung, Sungjin ^{[6
]}

Hong, Yu Ah ^{[7
]}

Hyun, Young Youl ^{[8
]}

Cho, Jang-Hee ^{[9
]}

Yoo, Kyung Don ^{[10
]}

Bae, Eunjin ^{[11
]}

Park, Woo Yeong ^{[12
]}

Sun, In O. ^{[13
]}

Kim, Dongryul ^{[14
]}

Kim, Hyunsuk ^{[15
]}

Hwang, Won Min ^{[16
]}

Song, Sang Heon ^{[17
]}

Shin, Sung Joon ^{[18
]}

机构：

[1] Soonchunhyang Univ, Dept Internal Med, Div Nephrol, Bucheon Hosp, Bucheon, South Korea

[2] Hallym Univ, Coll Med, Dept Internal Med, Div Nephrol,Hangang Sacred Heart Hosp, Seoul, South Korea

[3] Korea Univ, Coll Med, Dept Internal Med, Div Nephrol,Guro Hosp, Seoul, South Korea

[4] Yonsei Univ, Dept Internal Med, Div Nephrol, Wonju Coll Med, Wonju, South Korea

[5] Soonchunhyang Univ, Dept Internal Med, Div Nephrol, Seoul Hosp, Seoul, South Korea

[6] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Nephrol,Yeouido St Marys Hosp, Seoul, South Korea

[7] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Nephrol,Daejeon St Marys Hosp, Daejeon, South Korea

[8] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Nephrol,Sch Med, Seoul, South Korea

[9] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Div Nephrol,Dept Internal Med, Daegu, South Korea

[10] Univ Ulsan, Ulsan Univ Hosp, Dept Internal Med, Div Nephrol,Coll Med, Ulsan, South Korea

[11] Gyeongsang Natl Univ, Dept Internal Med, Div Nephrol, Changwon Hosp, Chang Won, South Korea

[12] Keimyung Univ, Dongsan Hosp, Dept Internal Med, Div Nephrol,Sch Med, Daegu, South Korea

[13] Presbyterian Med Ctr, Dept Internal Med, Div Nephrol, Jeonju, South Korea

[14] Catholic Univ Korea, Dept Internal Med, Div Nephrol, Incheon St Marys Hosp,Coll Med, Seoul, South Korea

[15] Hallym Univ, Coll Med, Dept Internal Med, Div Nephrol,Chuncheon Sacred Heart Hosp, Chunchon, South Korea

[16] Konyang Univ Hosp, Dept Internal Med, Div Nephrol, Daejeon, South Korea

[17] Pusan Natl Univ, Pusan Natl Univ Hosp, Dept Internal Med, Div Nephrol,Sch Med, Busan, South Korea

[18] Dongguk Univ, Ilsan Hosp, Dept Internal Med, Div Nephrol,Sch Med, Goyang, South Korea

来源：

KIDNEY RESEARCH AND CLINICAL PRACTICE | 2022年 / 41卷 / 02期

关键词：

Clinical decision-making; End-of-life care; Life-sustaining treatment; Patient-centered care; Physician preference; Shared; decision-making; FACILITATORS; PREFERENCES; DIALYSIS; BARRIERS; OUTCOMES; REGRET;

D O I：

10.23876/j.krcp.21.071

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Evidence of the ethical appropriateness and clinical benefits of shared decision-making (SDM) are accumulating. This study aimed to not only identify physicians' perspectives on SDM, and practices related to end-of-life care in particular, but also to gauge the effect of SDM education on physicians in Korea. Methods: A 14-item questionnaire survey using a modified Delphi process was delivered to nephrologists and internal medicine trainees at 17 university hospitals. Results: A total of 309 physicians completed the survey. Although respondents reported that 69.9% of their practical decisions were made using SDM, 59.9% reported that it is not being applied appropriately. Only 12.3% of respondents had received education on SDM as part of their training. The main obstacles to appropriate SDM were identified as lack of time (46.0%), educational materials and tools (29.4%), and education on SDM (24.3%). Although only a few respondents had received training on SDM, the proportion of those who thought they were using SDM appropriately in actual practice was high; the proportion of those who chose lack of time and education as factors that hindered the proper application of SDM was low. Conclusion: The majority of respondents believed that SDM was not being implemented properly in Korea, despite its use in actual practice. To improve the effectiveness of SDM in the Korean medical system, appropriate training programs and supplemental policies that guarantee sufficient application time are required.

引用

页码：242 / 252

页数：11

共 36 条

[1] Informed decision making in outpatient practice - Time to get back to basics [J].