BMC Med Inform Decis Mak - Incorporating patient and family preferences into evidence-based medicine.

Tópicos

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Resumo

CKGROUND: Clinicians are encouraged to practice evidence-based medicine (EBM) as well as patient-centered medicine. At times, these paradigms seem to be mutually exclusive and difficult to reconcile. It can become even more challenging when trying to include the preferences of the patient's family members. This paper discusses the basis for this quandary, providing examples of the real-world impact it has on diagnosis-seeking and treatment decision-making behaviors and how it might inform implementation of EBM practices.ANALYSIS: To further explore the role of friends and family in health-care decision making and to understand how patients and families introduce other considerations that may or may not be congruent with a strictly EBM approach, data from two research studies that examined healthcare-seeking behaviors are presented. Both studies explore how family and friends not only can influence health-care decisions but also may be a source of conflict for the patient and/or clinician.CONCLUSIONS: Illness is a biological and social process. Clinicians who engage in EBM need to acknowledge the social and cultural factors that affect the health-care encounter, understand the important role of those factors in health-care decision making, and expand the paradigm of EBM to incorporate sociocultural influences more explicitly. Moreover, recognition of the influences family members and other caregivers have within the clinical encounter--by offering opinions and participating in treatment-related decision making--is needed and could lead to more efficient and effective health care.

Resumo Limpo

ckground clinician encourag practic evidencebas medicin ebm well patientcent medicin time paradigm seem mutual exclus difficult reconcil can becom even challeng tri includ prefer patient famili member paper discuss basi quandari provid exampl realworld impact diagnosisseek treatment decisionmak behavior might inform implement ebm practicesanalysi explor role friend famili healthcar decis make understand patient famili introduc consider may may congruent strict ebm approach data two research studi examin healthcareseek behavior present studi explor famili friend can influenc healthcar decis also may sourc conflict patient andor clinicianconclus ill biolog social process clinician engag ebm need acknowledg social cultur factor affect healthcar encount understand import role factor healthcar decis make expand paradigm ebm incorpor sociocultur influenc explicit moreov recognit influenc famili member caregiv within clinic encounterbi offer opinion particip treatmentrel decis makingi need lead effici effect health care

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