醫病共享決策輔助工具於骨質疏鬆症照護

Shared Decision Aid for Osteoporosis Management

骨質疏鬆症為造成脆弱性骨折的關鍵危險因子，是高齡者重要的健康威脅。台灣50歲以上男性5位就有1位、女性10位就有4位符合骨質疏鬆症診斷，發生髖骨脆弱性骨折者，將有著高的死亡率與失能比例。然而由於骨質疏鬆症本身較常無明顯症狀，同時治療時也較難有直接感受，治療的順從性較不佳。透過醫病共享決策模式，將可增加病患對骨質疏鬆症了解，進一步提升病患病識感與改善治療順從性。因此，設計醫病共享決策模型於骨質疏鬆症照護時，將需具體呈現其風險、不確定性與對風險察覺程度。本文旨在闡明如何依據上述原則，進行設計一個應用於骨質疏鬆症照護之醫病共享決策輔助工具。

Osteoporosis is one of the major risk factors of fragility fractures and an important health threat in elderly. In Taiwan, one out of five men and four out of ten women met the diagnosed criteria of osteoporosis. Patients with hip fragility fractures have a high mortality and disability. However, most people with osteoporosis are asymptomatic and no tangible effect is experienced after treatments, which resulted in poor treatment compliance. Shared decision making (SDM) may raise awareness of the disease, thus improves patient insights and medical compliance. In the design of SDM models in osteoporosis management, disease risks, uncertainty and perception of risk should be specifically presented. This study is aimed to demonstrate how to design a patient decision aid (PDA) for osteoporosis managements according to the above suggestions.