脊椎退化疾病之醫病共享決策

Shared Decision Making for Management of Degenerative Spine Diseases

醫病共享決策（shared decision making, SDM）係指醫師提出具有實證驗證的治療方法，病人提出個人價值觀與好惡，共同討論後達成治療決策的過程。病患輔助工具（patient decision aid, PDA）是為病人所設計，能夠清楚明暸地實行醫病共享的輔助工具。台大醫院竹東分院自2017年5月成立院內SDM小組，並定期召開會議。由骨科醫師（本文第一作者）負責院內的機構推行實踐及教育訓練活動、民眾健康識能活動及臨床實踐，主題涵蓋各次專及各關節，此篇以「治療下背痛及坐骨神經痛及神經性跛行及脊椎狹窄及脊椎滑脫」主題為例，病人及家屬滿意度均高，並於2018年度榮獲醫療機構實踐績優獎。

Shared decision making (SDM) is a process of physician providing evidence-based treatment then patient stating personal value and preferences, and finally both parties deciding the treatment plan together after discussion. Patient decision aid (PDA) is a tool designed to assist patients to understand and execute SDM. SDM task force was established with regular meetings since May, 2017 by recruiting quality control center and representatives of patients and families in NTUH Chu-Tung Branch. Orthopaedic surgeon (the first author) was in charge of institutional enforcement, educational training, public awareness activities, and clinical practice of his SDM topics including all the subspecialties in Orthopaedics involving all articulating joints. This manuscript focused on the topic of ＂Treating low back pain, sciatica, neurogenic claudication, spinal stenosis, spondylolisthesis＂ which gained high satisfaction from patients and families. Such efforts gain publicities and were awarded with ＂2018 Institution Practice Excellency Award＂.