KMID : 1102220220410020242
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Kidney Research and Clinical Practice 2022 Volume.41 No. 2 p.242 ~ p.252
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Effect of shared decision-making education on physicians¡¯ perceptions and practices of end-of-life care in Korea
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Yu Byung-Chul
Han Mi-Yeun Ko Gang-Jee Yang Jae-Won Kwon Soon-Hyo Chung Sung-Jin Hong Yu-Ah Hyun Young-Youl Cho Jang-Hee Yoo Kyung-Don Bae Eun-Jin Park Woo-Yeong Sun In-O Kim Dong-Ryul Kim Hyun-Suk Hwang Won-Min Song Sang-Heon Shin Sung-Joon
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Abstract
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Background: Evidence of the ethical appropriateness and clinical benefits of shared decision-making (SDM) are accumulating. This study aimed to not only identify physicians¡¯ perspectives on SDM, and practices related to end-of-life care in particular, but also to gauge the effect of SDM education on physicians in Korea.
Methods: A 14-item questionnaire survey using a modified Delphi process was delivered to nephrologists and internal medicine trainees at 17 university hospitals.
Results: A total of 309 physicians completed the survey. Although respondents reported that 69.9% of their practical decisions were made using SDM, 59.9% reported that it is not being applied appropriately. Only 12.3% of respondents had received education on SDM as part of their training. The main obstacles to appropriate SDM were identified as lack of time (46.0%), educational materials and tools (29.4%), and education on SDM (24.3%). Although only a few respondents had received training on SDM, the proportion of those who thought they were using SDM appropriately in actual practice was high; the proportion of those who chose lack of time and education as factors that hindered the proper application of SDM was low.
Conclusion: The majority of respondents believed that SDM was not being implemented properly in Korea, despite its use in actual practice. To improve the effectiveness of SDM in the Korean medical system, appropriate training programs and supplemental policies that guarantee sufficient application time are required.
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KEYWORD
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Clinical decision-making, End-of-life care, Life-sustaining treatment, Patient-centered care, Physician preference, Shared decision-making
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