廖硕发

[摘要] 糖尿病为临床上较为常见的一种慢性疾病，受环境和遗传因素相互作用，造成胰岛素分泌不足、胰岛素对靶组织细胞的刺激作用减小，从而引发脂肪、蛋白质、水和电解质等代谢紊乱。糖尿病患者因个体差异而使临床症状也不尽相同，为了最准确、全面地了解患者病情和心理，需要医生加强与患者之间的交流沟通，践行医患共同决策原则，为糖尿病治疗提供重要参考依据。当前，医患共同决策这一医疗干预模式已经得到了临床医患的普遍认可和接受，其特点为：将严重不良后果发生率降至最低；综合评价后确认效果好；兼顾医疗水平与患者经济负担。要有效推行此种模式，关键是加强医患在诊疗过程中的决策共定，实现医患共治。

[关键词] 糖尿病俱乐部；医患共同决策；沟通交流；心理疏导；医患共治

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2016）03（a）-0197-02

Study on the Clinical Experience of Diagnosis and Treatment of Diabetes Club Patients with the Common Decision Model of Doctors and Patients

LIAO Shuo-fa

Department of internal medicine， Longling County People's Hospital of Yunnan Province，Baoshan，Yunnan Province，678300 China

[Abstract] Diabetes mellitus is a common chronic disease， which is caused by the interaction between environment and genetic factors， which causes the deficiency of insulin secretion and the stimulation of insulin on target tissue cells， which can lead to metabolic disorders such as fat， protein， water and electrolyte. Patients with diabetes due to individual differences and make clinical symptoms are not the same， in order to accurately and comprehensively understand the patient's condition and psychological， need to strengthen communication between doctors and patients， practice the principle of common decision-making， to provide an important reference for the treatment of diabetes. At present， the medical intervention model has been widely recognized and accepted by clinical doctors and patients， which is characterized by： the incidence of serious adverse consequences to the lowest； comprehensive evaluation after the confirmation effect is good； the medical level and the economic burden of patients. In order to effectively implement this model， the key is to strengthen the decision-making of the patient in the process of diagnosis and treatment.

[Key words] Diabetes club； Joint decision making；Communication； Psychological counseling； Medical treatment

糖尿病俱乐部的宗旨是以糖尿病病友为中心，加强对病友防治知识的宣传。鼓励和指导其规范配合治疗；营造互助互勉的良好氛围，使患者感受到温暖和关怀，消除患者负性情绪，提高生活质量。以这些宗旨为向导，需要强化医患共同决策这一概念。这样才能有效推行。共同决策主要特征有3个：医患共同参与；信息双方分享；治疗措施以双方达成共识为前提。在糖尿病患者诊疗过程中，加强医患之间的沟通交流，推行共同决策，可有效建立良好的医患关系，提高患者治疗的信心和治疗依从性，为成功治疗奠定了重要基础[1]。……