환자중심의료와 공유의사결정: 이론적 기초와 실행 방안

Abstract

Purpose: Shared decision-making (SDM) in healthcare is defined as a collaborative communication process among healthcare professionals, patients, and their primary caregivers to make decisions that reflect patients’ preferences and values. This is achieved by comparing multiple medically acceptable options based on medical evidence and clinical judgment. This review aims to examine the core concept of SDM and explore strategies for its implementation to advance patient-centered care in clinical practice. Current Concepts: SDM involves defining problems, presenting available options, explaining these options, identifying patients’ values and preferences, providing patient decision aids, and ultimately making decisions. To facilitate SDM, several strategies can be applied based on the conceptual model. These include training healthcare professionals, developing patient decision aids, and encouraging patients to participate actively in health-related decisions. Discussion and Conclusion: To successfully implement SDM in the Korean healthcare system, a shift from the prevailing paradigm is required, with a long-term perspective. To advance SDM, it is necessary to (1) develop an evidence-based Korean SDM model and training programs for healthcare professionals, (2) identify the most effective content and formats of patient decision aids for supporting patients with decisional needs, and (3) establish methods for institutionalizing SDM within clinical workflows to enable policy-level adoption.