Dilemma And Strategy Of Medical Decision-making For Elderly Patients With Malignant Tumor From The Perspective Of Social Work

In 1960s,with the emphasis on and defense of patients' rights,the concept of "patient-centered" holistic care gradually penetrated into the nursing field,which kicked off the reform of medical services under the background of medical patriarchy.In today's medical society,the doctor-patient relationship has undergone a structural transformation,and the modern medical concept of patients' participation in medical decision-making has gradually gained recognition.However,medical decision-making is a complicated process full of uncertainty and high risk,and biomedical model still dominates the actual medical field.The decision-making body of medical decision-making for elderly patients with malignant tumor is still influenced by many factors,which is full of difficulties.How should medical decision-makers of elderly patients with malignant tumors negotiate their own health beliefs? This is a complex and urgent problem.Social work is a profession that aims at pursuing social equity and empowering the disadvantaged groups,and it may provide another way for the best medical decision-making.Under the guidance of grounded theory,this study took the oncology department of X Hospital as the field research point,made a qualitative study on the medical decisionmaking of elderly patients with malignant tumors in the department,focused on the medical decision-making behavior,explored the formation mechanism and influencing factors of medical decision-making of elderly patients with malignant tumors,and found out the behavioral logic of medical decision-making of elderly patients with malignant tumors and the decision-making dilemma of decision-making subjects from the perspective of social work,and put forward service suggestions with rational thinking and perceptual care.It is found that the medical decision-making model of elderly patients with malignant tumors includes five stages,namely,the stage of medical examination,the stage of information exchange,the stage of decision-making and evaluation,the stage of decisionmaking and implementation and the stage of effect evaluation.The important decisionmaking subjects of medical decision-making for elderly patients with malignant tumors are patients,their families and medical teams.They are under multi-dimensional pressure in the different process of medical decision-making,which is difficult to resolve.These dilemmas not only come from the disease itself,but also are subject to distrust of doctorpatient relationship,imperfect medical security system and negative public opinion.At the same time,the elderly patients with malignant tumors naturally get more attention because of their weak status,but the needs of their families and medical staff who give them important support are ignored by the public.The healthy development of health industry needs the mutual improvement and interlocking of various systems.Therefore,this study puts forward the following suggestions for different stages of medical decisionmaking:(1)enhancing health awareness and preventing malignant tumors;(2)Improve the notification preparation and optimize the system division of labor;(3)Breaking down the information barrier and removing the charm medical myth;(4)Make comprehensive treatment arrangements and call for social equity;(5)Provide hospice care and complete medical services.