Zusammenfassung
Eine aktive Beteiligung von Patienten wird im Zuge einer zunehmend sich durchsetzenden Patientenorientierung als zentraler Faktor angesehen. Der vorliegende Beitrag konzentriert sich auf den Teilbereich der partizipativen Entscheidungsfindung (PEF). Dieses Konzept wird in Abgrenzung zu anderen Modellen medizinischer Entscheidungsfindung dargestellt und seine konkrete Umsetzung im Kontext der orthopädischen Behandlung vertieft. Erwartbare Effekte der PEF in der Orthopädie werden berichtet sowie Barrieren aufgezeigt, die einer Umsetzung im klinischen Alltag entgegenstehen können.
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Abel T, Sommerhalder K (2007) Gesundheitskompetenz: Eine konzeptuelle Einordnung. Institut für Sozial- und Präventivmedizin, Bern
Arterburn D, Wellman R, Westbrook E, Rutter C, Ross T, McCulloch D et al (2012) Introducing decision aids at group health was linked to sharply lower hip and knee surgery rates and costs. Health Affairs 31(9):2094–2104
Bieber C, Loh A, Ringel N, Eich W, Härte, M (2007) Patientenbeteiligung bei medizinischen Entscheidungen – Manual zur Partizipativen Entscheidungsfindung (Shared Decision Making). Universitätsklinikum Heidelberg
Bozic KJ, Belkora J, Chan V, Youm J, Zhou T, Dupaix J et al (2013) Shared decision making in patients with osteoarthritis of the hip and knee: results of a randomized controlled trial. J Bone Joint Surg 95(18):1633–1639
Bozic KJ, Chenok KE, Schindel J, Chan V, Huddleston JI 3rd, Braddock C 3rd et al (2014) Patient, surgeon, and healthcare purchaser views on the use of decision and communication aids in orthopaedic surgery: a mixed methods study. BMC Health Services Research 14:366
Charles C, Gafni A, Whelan T (1999) Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Social Science and Medicine 49(5):651–661
Chewning B, Bylund CL, Shah B, Arora NK, Gueguen JA, Makoul G (2012) Patient preferences for shared decisions: A systematic review. Patient Education and Counseling 86(1):9–18
Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P et al (2009) Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 10(2):113–130
Coulter A (1999) Paternalism or partnership? Patients have grown up-and there’s no going back. BMJ 319(7212):719–720
Coulter A (2012) Patient engagement – what works? J Ambulatory Care Management 35(2):80–89
Coulter A, Ellins J (2007) Effectiveness of strategies for informing, educating, and involving patients. BMJ 335:24–27
de Achaval S, Fraenkel L, Volk RJ, Cox V, Suarez-Almazor ME (2012) Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty. Arthritis Care Res 64(2):229–237
Dirmaier J, Härter M (2011) Stärkung der Selbstbeteiligung in der Rehabilitation. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 54(4):411–419
Duncan E, Best C, Hagen S (2010) Shared decision making interventions for people with mental health conditions. Cochrane Database of Systematic Reviews 1, Retrieved 2013. http://onlinelibrary.wiley.com/doi/2010.1002/14651858.CD14007297.pub14651852/abstract
Elwyn G, Dehlendorf C, Epstein RM, Marrin K, White J, Frosch DL (2014) Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems. Annals of Family Medicine 12(3):270–275
Elwyn G, Edwards A, Hood K, Robling M, Atwell C, Russell I et al (2004) Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice. Family Practice 21(4):337–346
Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P et al (2012) Shared decision making: a model for clinical practice. J General Internal Med 27(10):1361–1367
Elwyn G, Frosch D, Volandes AE, Edwards A, Montori VM (2010) Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. Medical Decision Making 30(6):701–711
Elwyn G, O’Connor A, Stacey D, Volk R, Edwards A, Coulter A et al (2006) Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ 333(7565):417–419
Elwyn G, Scholl I, Tietbohl C, Mann M, Edwards AG, Clay C et al (2013) ″Many miles to go ...″: a systematic review of the implementation of patient decision support interventions into routine clinical practice. BMC Medical Informatics and Decision Making 13(Suppl 2):S14
Fraenkel L, Rabidou N, Wittink D, Fried T (2007) Improving informed decision-making for patients with knee pain. J Rheumatol 34(9):1894–1898
Frosch DL, May SG, Rendle KA, Tietbohl C, Elwyn G (2012) Authoritarian physicians and patients’ fear of being labeled ’difficult’ among key obstacles to shared decision making. Health Affairs (Millwood) 31(5):1030–1038
Gaissmaier W, Gigerenzer G (2013) Wenn fehlinformierte Patienten versuchen, informierte Gesundheitsentscheidungen zu treffen. In: Gigerenzer G, Muir Gray JA (Hrsg) Bessere Ärzte, bessere Patienten, bessere Medizin. Aufbruch in ein transparantes Gesundheitswesen. MWV Medizinisch-Wissenschaftliche Verlagsgesellschaft, Berlin, S 29–44
Gigerenzer G, Gaissmaier W, Kurz-Milcke E, Schwartz LM, Woloshin S (2008) Helping doctors and patients: Make sense of health statistics. Psychological Science in the Public Interest 8(2):53–96
Hamann J, Hein J, Kissling W (2005) Patientenempowerment – eine wirksame Strategie zur Förderung der Patientenbeteiligung bei medizinischen Entscheidungen. In: Härter M, Loh A, Spies C (Hrsg) Gemeinsam entscheiden – erfolgreich behandeln. Deutscher Ärzte-Verlag, Köln, S 45–51
Härter M (2004) Partizipative Entscheidungsfindung (Shared Decision Making) – ein von Patienten, Ärzten und der Gesundheitspolitik geforderter Ansatz setzt sich durch (Editorial). Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 98(2):89–92
Härter M, Müller H, Dirmaier J, Donner-Banzhoff N, Bieber C, Eich W (2011) Patient participation and shared decision making in Germany – history, agents and current transfer to practice. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 105(4):263–270
Hawkins RP, Kreuter M, Resnicow K, Fishbein M, Dijkstra A (2008) Understanding tailoring in communicating about health. Health Education Research 23(3):454–466
Hertwig R, Buchan H, Davis DA, Gaissmaier W, Härter M, Kolpatzik K et al (2013) Wie werden Gesundheitsfachkräfte und Patienten im Jahr 2020 zusammenarbeiten? Ein Manifest für den Wandel. In: Gigerenzer G, Muir Gray JA (Hrsg) Bessere Ärzte, bessere Patienten, bessere Medizin. Aufbruch in ein transparentes Gesundheitswesen. MWV Medizinisch-Wissenschaftliche Verlagsgesellschaft, Berlin, S 325–347
Holman HR (2005) Chronic disease and the healthcare crisis. Chronic Illness 1(4):265–279
Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA (2008) Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychotherapy and Psychosomatics 77(4):219–226
Kinnersley P, Edwards A, Hood K, Ryan R, Prout H, Cadbury N et al (2008) Interventions before consultations to help patients address their information needs by encouraging question asking: systematic review. BMJ 337:a485
Kopke S, Kasper J, Muhlhauser I, Nubling M, Heesen C (2009) Patient education program to enhance decision autonomy in multiple sclerosis relapse management: a randomized-controlled trial. Multiple Sclerosis 15(1):96–104
Légaré F, Ratte S, Gravel K, Graham ID (2008) Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions. Patient Education and Counseling 73(3):526–535
Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID et al (2010) Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database of Systematic Reviews 5, Retrieved 2013, from. http://onlinelibrary.wiley.com/doi/2010.1002/14651858.CD14006732.pub14651852/abstract
Légaré F, Witteman HO (2013) Shared decision making: examining key elements and barriers to adoption into routine clinical practice. Health Affairs (Millwood) 32(2):276–284
Loh A, Simon D, Wills C, Kriston L, Niebling W, Härter M (2007) The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial. Patient Education and Counseling 67(3):324–332
McCaffery KJ, Smith SK, Wolf M (2010) The challenge of shared decision making among patients with lower literacy: a framework for research and development. Medical Decision Making 30(1):35–44
Melchior H, Schulz H, Härter M (2014) Stellenwert regionaler Variationen bei depressiven Erkrankungen und Implikationen für die Versorgungsforschung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 57:224–233
Müller-Engelmann M, Keller H, Donner-Banzhoff N, Krones T (2010) Shared decision making in medicine: the influence of situational treatment factors. Patient Education and Counseling 82(2):240–246
Peek ME, Wilson SC, Gorawara-Bhat R, Odoms-Young A, Quinn MT, Chin MH (2009) Barriers and facilitators to shared decision-making among African-Americans with diabetes. J General Intenal Med 24(10):1135–1139
Scholl I, Zill JM, Härter M, Dirmaier J (2014) An integrative model of patient-centeredness – a systematic review and concept analysis. PLoS One 9(9):e107828
Shepherd HL, Barratt A, Trevena LJ, McGeechan K, Carey K, Epstein RM et al (2011) Three questions that patients can ask to improve the quality of information physicians give about treatment options: a cross-over trial. Patient Education and Counseling 84(3):379–385
Slover J, Shue J, Koenig K (2012) Shared decision-making in orthopaedic surgery. Clin Orthop Relat Res 470(4):1046–1053
Stacey D, Kryworuchko J, Bennett C, Murray MA, Mullan S, Legare F (2012) Decision coaching to prepare patients for making health decisions: a systematic review of decision coaching in trials of patient decision AIDS. Med Decis Making 32(3):E22–E33
Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB et al (2014) Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 1:CD001431
Wegwarth O, Gigerenzer G (2011) Risikokommunikation: Risiken und Unsicherheiten richtig verstehen lernen. Deutsches Ärzteblatt 108(9):A-448
Weiss BD (2007) Health literacy and patient safety: Help patients understand. Manual for clinicians, 2. Aufl. American Medical Association Foundation and American Medical Association, Chicago IL
Wennberg J, Gittelsohn (1973) Small area variations in health care delivery. Science 182(4117):1102–1108
Whitney SN (2003) A new model of medical decisions: Exploring the limits of shared decision making. Medical Decision Making 23(4):275–280
Youm J, Chenok KE, Belkora J, Chiu V, Bozic KJ (2013) The emerging case for shared decision making in orthopaedics. Instructional Course Lectures 62:587–594
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Dirmaier, J., Härter, M. (2016). Diagnoseaufklärung, Information und Entscheidung über Behandlungen – Patientenbeteiligung und partizipative Entscheidungsfindung. In: Jerosch, J., Linke, C. (eds) Patientenzentrierte Medizin in Orthopädie und Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48081-6_2
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