三种决策的概念辨析对我国医疗决策实践的启示

在医疗决策领域，相对于共享决策，还有代理决策、支持决策两个SDM概念。系统回顾与比较了三种SDM决策类型的概念起源、定义特征及应用领域，同时梳理了三种概念之间的层次关系及内涵异同。三种SDM都是在“以患者为中心”文化驱动下的医疗决策类型，但其适用人群不同，且存在一定的隶属关系。基于中西方文化背景差异，进一步探讨了三种SDM概念对我国医疗决策实践的启示与建议，旨在为我国医疗决策工作的完善与提高提供更多依据。

A Conceptual Analysis of Three Decision-making Types and Their Implications for Practice in China

Within the realm of healthcare decision-making, shared decision-making (SDM1) stands alongside two distinct concepts, namely surrogate decision-making (SDM2) and supported decision-making (SDM3). This paper conducted a comparative analysis of the conceptual origins, defining characteristics, and applications domains of these three SDM decision types. In addition, the hierarchical relationships, connotative similarities and differences among them are elucidated. While all three types align with the "patient-centered care" culture, they cater to different populations with specific affiliations. In light of variances between Chinese and Western cultural contexts, this paper delves into the implications and recommendations of these three SDM concepts for healthcare decision-making practices in China. The aim is to furnish additional evidence supporting the refinement and advancement of decision-making within the Chinese healthcare system.