醫病共享決策於物理治療的慢性疼痛介入

Shared Decision Making in Physical Therapy for Patients with Chronic

物理治療師處理臨床問題時，是經過綜合評估臨床推理後，給予有實證性的物理治療介入。當面對較為複雜且尚無明確臨床指引的臨床問題時，物理治療介入的方式，通常會依照醫療給予方的偏好，病人則沒有參與討論的機會。相對於如此單面向的知情同意；醫病共享決策則是由醫療方提供足夠的資訊，病人有機會表達個人想法，在醫病雙方經過溝通後，得出雙方同意的臨床介入決定。本文以物理治療在慢性疼痛的介入，介紹醫病共享決策的運用模式。

Physical therapist uses evaluation and clinical reasoning process to provide evidence-based intervention in clinical environment. If clinical practice guideline is lacking, the intervention is decided based on preference of physical therapist while patient has no chance to involve it. In comparison to informed consent which is a one-way direction; shared decision making is an interaction between professional provider and patient. Professionals provide enough information. At the same time, patient provides personal thinking and considerations. The clinical decision was made after discussion between professional and patient. In this paper, we will use shared decision-making process in physical therapy to deal with chronic pain.