Research design and methods of establishing the conceptual framework of shared decision-making in Chinese medicine_Chinese Journal of Evidence-Based Medicine

Authors：

CAO Wencong ¹ , CHENG Ting ¹ , LI Meichen ¹ , TANG Qi ¹ , ZHOU Li ^2,3 , LI Geng ^2,3 , CHEN Xiankun ^2,3 ,  WEN Zehuai ^2,3,4

1. Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
2. Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, P. R. China;
3. State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, P. R. China;
4. Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;

Corresponding author：

WEN Zehuai, Email: wenzh@gzucm.edu.cn

Keywords：

Chinese medicine; Shared decision making; Patient-centred; Conceptual framework; Methodology

DOI：

10.7507/1672-2531.202409097

Video：

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Shared decision making (SDM), as a healthcare service model, requires clinical practice to follow the “patient-centred” medical principle and emphasizes patient participation in the medical decision-making process, which promotes medical equality and improves the quality and effectiveness of healthcare services. However, its methodology has not yet been introduced into the field of Chinese medicine (CM), and there is still a lack of clear guidance on how to implement SDM in clinical practice. This study provided the method of establishing the conceptual framework of SDM in CM, introducing multiple methods according to evidence-based medicine, and conducing an implementation study to explore the applicability of SDM model in CM clinical practice, with the aim of providing references for the application of the SDM in the clinical practice of CM in the future.

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2.	Fricchione G. Mind body medicine: a modern bio-psycho-social model forty-five years after Engel. Biopsychosoc Med, 2023, 17(1): 12.
3.	Marsac ML, Kassam-Adams N, Delahanty DL, et al. Posttraumatic stress following acute medical trauma in children: a proposed model of bio-psycho-social processes during the peri-trauma period. Clin Child Fam Psychol Rev, 2014, 17(4): 399-411.
4.	Rassoulian A, Löffler-Stastka H. The search for meaning in medicine when confronted with life-threatening illness - how to include a bio-psycho-social model into health-care. Psychiatr Danub, 2022, 34(3): 398-406.
5.	Smith R, Rennie D. Evidence-based medicine-an oral history. JAMA, 2014, 311(4): 365-367.
6.	Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet, 2017, 390(10092): 415-423.
7.	Huh J, Louis-Ugbo J, Hembree WC, et al. 2023 Evidence-based medicine (EBM) update. Foot Ankle Int, 2024, 45(5): 547-554.
8.	Kim WM. From evidence-based medicine to patient-centered care. Korean J Anesthesiol, 2023, 76(4): 265-266.
9.	Smith ER. Evidence-based decision-making. Can J Cardiol, 2003, 19(6): 729-730.
10.	Hoffmann TC, Montori VM, Del Mar C. The connection between evidence-based medicine and shared decision making. JAMA, 2014, 312(13): 1295-1296.
11.	王伟, 张铁山, 王磊. 基于循证医学临床决策模式研究. 医学与社会, 2005, (8): 35-37.
12.	赵建平, 段蕴铀, 程巧燕, 等. 循证医学决策模式的建立与应用. 解放军医院管理杂志, 2003, (4): 345-346.
13.	余绍福, 王云云, 邓通, 等. 医患共同决策系列之一: 医患共同决策的国内外发展现状. 医学新知, 2020, 30(2): 159-167.
14.	Elwyn G. Shared decision making: What is the work. Patient Educ Couns, 2021, 104(7): 1591-1595.
15.	National Institute for Health and Care Excellence (NICE). Shared decision making. 2021.
16.	Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean. (or it takes at least two to tango). Soc Sci Med, 1997, 44(5): 681-692.
17.	Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns, 2006, 60(3): 301-312.
18.	Bomhof-Roordink H, Gärtner FR, Stiggelbout AM, et al. Key components of shared decision making models: a systematic review. BMJ Open, 2019, 9(12): e031763.
19.	Jabareen Y. Building a conceptual framework: philosophy, definitions, and procedure. Int J Qual Methods, 2009, 8(4): 49-62.
20.	McMeekin N, Wu O, Germeni E, et al. How methodological frameworks are being developed: evidence from a scoping review. BMC Med Res Methodol, 2020, 20(1): 173.
21.	Joseph-Williams N, Elwyn G, Edwards A. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Educ Couns, 2014, 94(3): 291-309.
22.	Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol, 2008, 8: 45.
23.	Noble H, Mitchell G. What is grounded theory. Evid Based Nurs, 2016, 19(2): 34-35.
24.	Giacomini MK, Cook DJ. Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA, 2000, 284(3): 357-362.
25.	Côté L, Turgeon J. Appraising qualitative research articles in medicine and medical education. Med Teach, 2005, 27(1): 71-75.
26.	Patton MQ. Qualitative evaluation and research methods. Int J Inform Manage, 1990.
27.	谢雁鸣, 廖星. 基于扎根理论的定性数据主题抽题分析法探析. 辽宁中医杂志, 2008, (11): 1665-1668.
28.	屈满学. 略论定性研究的信度、效度及其伦理道德问题. 当代教育论坛, 2006, (3): 66-67.
29.	陈向明. 定性研究中的效度问题. 教育研究, 1996, (7): 52-58.
30.	Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res, 1999, 34(5 Pt 2): 1189-1208.
31.	Denzin NK. Sociological methods: a sourcebook. New York: Routledge, 2017.
32.	邱瑞瑾, 孙杨, 钟长鸣, 等. 中医核心证候指标集的构建思路. 中国循证医学杂志, 2021, 21(11): 1353-1357.
33.	Elwyn G, Lloyd A, Joseph-Williams N, et al. Option grids: shared decision making made easier. Patient Educ Couns, 2013, 90(2): 207-212.
34.	Nijhuis FAP, Elwyn G, Bloem BR, et al. Improving shared decision-making in advanced Parkinson's disease: protocol of a mixed methods feasibility study. Pilot Feasibility Stud, 2018, 4: 94.
35.	老膺荣. 构建类风湿关节炎中医复杂干预方案的方法学初步研究. 广州: 广州中医药大学, 2008.

1. Grotkamp S, Cibis W, Brüggemann S, et al. Personal factors of the bio-psycho-social model (WHO): a revised classification by the German Society for Social Medicine and Prevention (DGSMP). Gesundheitswesen, 2020, 82(1): 107-116.
2. Fricchione G. Mind body medicine: a modern bio-psycho-social model forty-five years after Engel. Biopsychosoc Med, 2023, 17(1): 12.
3. Marsac ML, Kassam-Adams N, Delahanty DL, et al. Posttraumatic stress following acute medical trauma in children: a proposed model of bio-psycho-social processes during the peri-trauma period. Clin Child Fam Psychol Rev, 2014, 17(4): 399-411.
4. Rassoulian A, Löffler-Stastka H. The search for meaning in medicine when confronted with life-threatening illness - how to include a bio-psycho-social model into health-care. Psychiatr Danub, 2022, 34(3): 398-406.
5. Smith R, Rennie D. Evidence-based medicine-an oral history. JAMA, 2014, 311(4): 365-367.
6. Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet, 2017, 390(10092): 415-423.
7. Huh J, Louis-Ugbo J, Hembree WC, et al. 2023 Evidence-based medicine (EBM) update. Foot Ankle Int, 2024, 45(5): 547-554.
8. Kim WM. From evidence-based medicine to patient-centered care. Korean J Anesthesiol, 2023, 76(4): 265-266.
9. Smith ER. Evidence-based decision-making. Can J Cardiol, 2003, 19(6): 729-730.
10. Hoffmann TC, Montori VM, Del Mar C. The connection between evidence-based medicine and shared decision making. JAMA, 2014, 312(13): 1295-1296.
11. 王伟, 张铁山, 王磊. 基于循证医学临床决策模式研究. 医学与社会, 2005, (8): 35-37.
12. 赵建平, 段蕴铀, 程巧燕, 等. 循证医学决策模式的建立与应用. 解放军医院管理杂志, 2003, (4): 345-346.
13. 余绍福, 王云云, 邓通, 等. 医患共同决策系列之一: 医患共同决策的国内外发展现状. 医学新知, 2020, 30(2): 159-167.
14. Elwyn G. Shared decision making: What is the work. Patient Educ Couns, 2021, 104(7): 1591-1595.
15. National Institute for Health and Care Excellence (NICE). Shared decision making. 2021.
16. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean. (or it takes at least two to tango). Soc Sci Med, 1997, 44(5): 681-692.
17. Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns, 2006, 60(3): 301-312.
18. Bomhof-Roordink H, Gärtner FR, Stiggelbout AM, et al. Key components of shared decision making models: a systematic review. BMJ Open, 2019, 9(12): e031763.
19. Jabareen Y. Building a conceptual framework: philosophy, definitions, and procedure. Int J Qual Methods, 2009, 8(4): 49-62.
20. McMeekin N, Wu O, Germeni E, et al. How methodological frameworks are being developed: evidence from a scoping review. BMC Med Res Methodol, 2020, 20(1): 173.
21. Joseph-Williams N, Elwyn G, Edwards A. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Educ Couns, 2014, 94(3): 291-309.
22. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol, 2008, 8: 45.
23. Noble H, Mitchell G. What is grounded theory. Evid Based Nurs, 2016, 19(2): 34-35.
24. Giacomini MK, Cook DJ. Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA, 2000, 284(3): 357-362.
25. Côté L, Turgeon J. Appraising qualitative research articles in medicine and medical education. Med Teach, 2005, 27(1): 71-75.
26. Patton MQ. Qualitative evaluation and research methods. Int J Inform Manage, 1990.
27. 谢雁鸣, 廖星. 基于扎根理论的定性数据主题抽题分析法探析. 辽宁中医杂志, 2008, (11): 1665-1668.
28. 屈满学. 略论定性研究的信度、效度及其伦理道德问题. 当代教育论坛, 2006, (3): 66-67.
29. 陈向明. 定性研究中的效度问题. 教育研究, 1996, (7): 52-58.
30. Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res, 1999, 34(5 Pt 2): 1189-1208.
31. Denzin NK. Sociological methods: a sourcebook. New York: Routledge, 2017.
32. 邱瑞瑾, 孙杨, 钟长鸣, 等. 中医核心证候指标集的构建思路. 中国循证医学杂志, 2021, 21(11): 1353-1357.
33. Elwyn G, Lloyd A, Joseph-Williams N, et al. Option grids: shared decision making made easier. Patient Educ Couns, 2013, 90(2): 207-212.
34. Nijhuis FAP, Elwyn G, Bloem BR, et al. Improving shared decision-making in advanced Parkinson's disease: protocol of a mixed methods feasibility study. Pilot Feasibility Stud, 2018, 4: 94.
35. 老膺荣. 构建类风湿关节炎中医复杂干预方案的方法学初步研究. 广州: 广州中医药大学, 2008.

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