末期攝護腺癌之醫病共享決策

Shared Decision Making for Terminal Prostate Cancer

醫病共享決策（shared decision making, SDM）是病患與醫師共同參與醫療決策的過程。醫療人員在有限的門診時間，要協助病人做出最合適的醫療決策，對醫療人員是一個很大的挑戰。SDM已經應用在許多醫療領域。此篇文章討論醫病共享決策模式在泌尿科領域的運用。其中，癌症是威脅生命的重大疾病，隨著醫療進步，癌症有更多種治療方式，需考量層面很多，更是困難耗時的決策過程。本文將以轉移性前列腺癌為例，討論應用醫病共享決策的應用，如何使得醫病溝通更有效率，也探討各種主觀和客觀的限制，及未來的發展。

Shared decision making (SDM) is a collaborative approach in medical care that improves the quality of medical decisions by helping patients choose options concordant with personal values and in accordance with best practice of scientific evidence. The increasing focus on patient-centered care has made SDM adopted more and more common in in recent years. With the progress in prostate cancer therapies, patients with metastatic prostate cancer presented the benefits and harms of different health care choices. In this review, we will discuss the application of SDM in metastatic prostate cancer and how is SDM capable of coming to shared decision making in clinical practice. The review will also discuss the limitations and prospective development of SDM in the urological field.