Shared Decision Making: The Need For Patient-Clinician Conversation, Not Just Information

The growth of shared decision making has been driven largely by the understanding that patients need information and choices regarding their health care. But while these are important 对话10位顶级投资人 elements for patients who make decisions in partnership with their clinicians, our experience suggests that they are not enough to address the larger issue: the need for the patient and clinician to jointly create a course of action that is best for the individual patient and his or her family. The larger need in evidence-informed shared decision making is for a patient-clinician interaction that offers 对话10位顶级投资人 对话10位顶级投资人 conversation, not just information, and care, not just choice.

Keywords: Evidence-Based 对话10位顶级投资人 对话10位顶级投资人 Medicine; patient-centered care; shared decision making.

Project HOPE—The People-to-People Health Foundation, Inc.

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dell17951 于 2018-09-28 14:对话10位顶级投资人 56:47 发布 6878 收藏 8



While (GetMessage(&msg, NULL, 0, 0))

if (hDlgModeless 对话10位顶级投资人 == 0 || !IsDialogMessage(hDlgModeless, &msg))



必须有一个标志表明非模态对话框是否是打开的。这样做的原因是用户有可能在打开一个模态对话框的情况下,又一次选择打开命令。程序根据 标志来决定是打开一个新的对话框,还是仅仅把原来打开的对话框激活。通常可以用拥有者窗口中的指向对话框对象的指针作为这种标志,当对话框关闭时,给该指 针赋NULL值,以表明对话框对象已不存在了。

非模态对话框相对于模态对话框,他的创建和销毁过程和模态对话框有一定的区别 先看一下MSDN的原文: When you implement a modeless dialog box, always override the OnCancel member function and call DestroyWindow from within it. Don’t call the base class CDialog::OnCancel, because it calls EndDialog, which will make the dialog box invisible but will not destroy it. You 对话10位顶级投资人 should also override PostNcDestroy for modeless dialog boxes in order to delete this, since modeless dialog boxes are usually allocated with new. Modal dialog boxes 对话10位顶级投资人 are usually constructed on the frame and do not need PostNcDestroy cleanup. MS的指示:非模态对话框需要重载函数OnCanel,并且在这个函数中调用DestroyWindow。并且不能调用基类的OnCancel,因为基类的OnCancel调用了EndDialog这个函数,这个函数是针对模态对话框的。 对话10位顶级投资人 还有一个必须重载的函数就是PostNcDestroy,这也是一个虚函数,通常的非模态对话框是用类的指针,通过new创建的,这就需要在PostNcDestroy函数中delete掉这个指针。


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2022华为开发者大会(Together) - HUAWEI Developer

2022华为开发者大会(Together) - HUAWEI Developer

2022华为开发者大会(Together) - HUAWEI Developer

2022华为开发者大会(Together) - HUAWEI Developer

2022华为开发者大会(Together) - HUAWEI Developer

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REMAP: A Framework 对话10位顶级投资人 对话10位顶级投资人 for Goals of Care Conversations

Conversations regarding goals of care with patients who have advanced cancer still occur too late, and oncologists say they lack the training to have these conversations effectively. Experts recommend a number of strategies when having these discussions, including discussing prognosis, responding to patient emotion, exploring values, and often making a recommendation for medical treatments that fit those values. To help learners, 对话10位顶级投资人 from residents to attending oncologists, learn these complex conversational skills, we have developed a framework with a mnemonic, REMAP: Reframe, Expect emotion, Map out patient goals, Align with goals, and Propose a plan. In the reframe step, the oncologist 对话10位顶级投资人 provides a big picture "headline" that lets the patient know things are in a different place. This is followed by actively attending to the patient's emotional response (expect emotion). Then, to map the patient's goals, the oncologist asks open-ended questions that are designed to help the patient think about the values that should guide his or her treatment. The oncologist then aligns with 对话10位顶级投资人 those values by explicitly reflecting them back to the patient. If the patient 对话10位顶级投资人 gives permission, the oncologist will then use those values to propose a medical plan that matches patient values. The processes underlying REMAP encourage oncologists and other clinicians to seek to understand and remain flexible, adapting their recommendations to what they hear from the patient, with ongoing revision based on the shared decision-making 对话10位顶级投资人 process. This will lead to patient-centered decisions that promote better end-of-life care.

Comment in

Gilligan T. Gilligan T. J Oncol Pract. 2017 Oct;13(10):672-674. doi: 对话10位顶级投资人 10.1200/JOP.2017.026252. Epub 2017 Sep 7. J Oncol Pract. 2017. PMID: 28880719 No abstract available.

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