醫病共享決策於良性攝護腺增生手術與非手術處理的應用—單一區域教學醫院報告

盧致誠^1.2 張基生³ 范文宙¹

奇美醫療財團法人柳營奇美醫院 外科部 泌尿外科

shared decision-making for patients with Benign prostatic hyperplasia—a regional teaching hospital experience  

Chih-Cheng Lu^1.2, Chi-Sheng Chang³ , Wen-Chou Fan¹

¹Division of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan

²Department of Information Management, National Chung Cheng University, Chiayi

³Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin

Purpose:

The treatment for symptomatic benign prostatic hyperplasia (BPH) includes non-surgical and surgical methods. This study was to explore the possibility of shared decision-making (SDM) tools to be helpful or not for the patients who encountered the decision for surgery for their urologic problems.

Materials and Methods:

This was a prospective study. Development of SDM tools was based on both physician and patients on decision-making choices, symptoms scores, supportive laboratory options, questionnaires from evidence-based medicine, integrated treatment options from documented clinical practice guidelines and treatment preferences of medical staff of the hospital. Then SDM was applied to the clinical patients. Feedback scoring was presented by percentage.  

Results:

Ten patients who had been treated for BPH and ten medical staff to give feedback for developing the SDM tools. In 2022, for patients with BPH but facing difficulties or doubts about the surgical or non-surgical treatment options, were applied the SDM as a decision-making aids. Ten patients were enrolled. The positive feedback and approval of the ten patients visited was more than 87% in several aspects: to clarify a decision must be made; to make a ready decision; advantages and disadvantages of choices; engagement of discussion; questions well answered by the doctors; and to express the patients most concerned. In February 2023, this program had won the best innovation award and the best team work award in the contest of National Health Quality Award 2022 held by the Joint Commission of Taiwan.

Conclusion:

In the present study, BPH is a common urological problem among men; however, making a treatment decision whether surgery or not from the patient could be very difficult. SDM could help the patients decide more clearly and accountably. SDM is also helpful for both physicians and patients. Long term study is needed.