Special Issue / Schwerpunkt| Volume 123, P66-68, June 2017

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The state of shared decision making in Malaysia

  • Yew Kong Lee
    Corresponding author: Prof. Yew Kong Lee, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
    Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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  • Chirk Jenn Ng
    Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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      Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors’ duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making.


      Erste Aktivitäten im Zusammenhang mit partizipativer Entscheidungsfindung (PEF) setzten in Malaysia um 2010 ein. Auch wenn das Konzept noch nicht weit verbreitet ist, bestehen Möglichkeiten, PEF sowohl im öffentlichen als auch im privaten Gesundheitssektor zu implementieren. Malaysia ist durch eine multikulturelle Gesellschaft geprägt, sodass verschiedene kulturelle Komponenten Einfluss auf die medizinische Entscheidungsfindung nehmen (z. B. Sprachunterschiede, ärztlicher Paternalismus, starke Familieneinbindung, religiöse Überzeugungen und Komplementärmedizin). Auf der politischen Ebene spricht das Gesundheitsministerium zunehmend von patientenzentrierter Versorgung als einem Bestandteil der Gesundheitsversorgung, während in den Bestimmungen der malaysischen Ärztekammer über die ärztlichen Pflichten von Kooperationspartnerschaften als Ziel der Arzt-Patient-Beziehung die Rede ist. Die aktuelle Forschung zum Thema PEF beinhaltet Grundlagenerhebungen über Entscheidungspräferenzen, die Erstellung und Implementierung von lokal erstellten Entscheidungshilfen für Patienten und die Durchführung von PEF-Schulungen und -Workshops. Ein Großteil dieser Forschungstätigkeit erfolgt in öffentlichen Universitäten. Insgesamt steckt PEF in Malaysia derzeit noch in den Kinderschuhen. Allerdings setzen sich das Gesundheitsministerium sowie akademische Einrichtungen zunehmend mit diesem Thema auseinander, und es werden vermehrt Anstrengungen unternommen, um Forschungsarbeiten zu PEF durchzuführen, medizinische Entscheidungshilfen für Patienten zu entwickeln und eine landesweite Diskussion über die Beteiligung von Patienten an der medizinischen Entscheidungsfindung anzustoßen.



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