关于决策质量的主观衡量标准。

IF 1.7 2区 哲学 Q2 ETHICS
Bioethics Pub Date : 2024-04-24 DOI:10.1111/bioe.13291
Jasper Debrabander
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引用次数: 0

摘要

在以人为本的医疗护理时代,支持患者对自己的护理做出正确的决定显得尤为重要。为病人提供这种支持的一种方式是病人决策辅助工具(PDA)。从患者手册到网络工具,PDA 明确说明了患者面临的决定,告知他们医疗选择,帮助他们澄清和讨论自己的价值观,并最终做出决定。然而,围绕掌上电脑有效性研究的讨论仍在继续。在本文中,我将重点讨论两种主观的决策质量测量方法,它们在 PDA 的有效性研究中被广泛用作结果测量方法(即决策冲突量表(DCS)和后悔测量方法)。尽管这些测量工具在科学文献中引起了批判性的关注,但生命伦理学者几乎没有参与其中。因此,我着手分析决策冲突量表和后悔量表的(不同分量表)与惠益和自主等伦理原则之间的关系。根据这一分析,我将澄清一些关于在掌上电脑有效性研究中使用这些决策质量测量方法的讨论。这应有助于我们将评估掌上电脑的方式与伦理原则统一起来,避免我们为支持病人就其护理做出正确决定而做出的尝试指向不道德的方向,而这正是以人为本的护理的核心。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
On subjective measures of decision quality

In times of person-centered care, it is all the more important to support patients in making good decisions about their care. One way to offer such support to patients is by way of Patient Decision Aids (PDAs). Ranging from patient brochures to web-based tools, PDAs explicitly state the decisions patients face, inform them about their medical options, help them to clarify and discuss their values, and ultimately make a decision. However, lingering discussions surround effectiveness research on PDAs. In this article, I focus on two subjective measures of decision quality that are widely used as outcome measures in effectiveness research on PDAs (i.e., the Decisional Conflict Scale (DCS) and measures of regret). Although these measurement instruments have attracted critical attention in the scientific literature, bioethicists have hardly engaged with them. Therefore, I set myself to analyze the relationship between (the different subscales of) the DCS and measures of regret, on the one hand, and ethical principles such as beneficence and autonomy, on the other hand. In light of that analysis, I will clarify some discussions regarding the use of these measures of decision quality in effectiveness research on PDAs. This should help us to align the way we evaluate PDAs with ethical principles and avoid that our attempts to support patients in making good decisions about their care that is so central to person-centered care point in unethical directions.

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来源期刊
Bioethics
Bioethics 医学-医学:伦理
CiteScore
4.20
自引率
9.10%
发文量
127
审稿时长
6-12 weeks
期刊介绍: As medical technology continues to develop, the subject of bioethics has an ever increasing practical relevance for all those working in philosophy, medicine, law, sociology, public policy, education and related fields. Bioethics provides a forum for well-argued articles on the ethical questions raised by current issues such as: international collaborative clinical research in developing countries; public health; infectious disease; AIDS; managed care; genomics and stem cell research. These questions are considered in relation to concrete ethical, legal and policy problems, or in terms of the fundamental concepts, principles and theories used in discussions of such problems. Bioethics also features regular Background Briefings on important current debates in the field. These feature articles provide excellent material for bioethics scholars, teachers and students alike.
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