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ǛǆƷ~ɐȠ¸Ê (2014). SNpx~GpbTx%°ĻƎĮ ×Ǔ%ǧ, 24(1), 57-74
Alston, C., Berger, Z. D., Brownlee, S., Elwyn, G., Fowler
Jr., F. J., Hall, L. K. , Montori, V. M., Moulton, B.,Paget, L., Haviland-Shebel, B., Singerman, R.,Walker, J., Wynia, M. K., and Henderson, D. (2014).
Shared Decision-Making Strategies for Best Care:
Patient Decision Aids, Institute of Medicine of theNational Academies
Elwyn, G., Edwards, A., Wensing, M., Hood, K., Atwell, C.,and Grol, R. (2003). Shared decision making:developing the OPTION scale for measuring patient
involvement, Quality and Safety in Health Care,12(2), 93-99.
ǨʂÜĔ~ĊʂȝŸ (2015). ȨÅ¥ 8ĕ-B{cDm\~L{R{[ ơƪǣǮ
Ǩǆƭ~ƤåƬƙ(ȇȞ) (2016). fxPwYvN ʈ°ĻŬȔ)űGz\ Ď¬ɽżĹHLS-EU Consortium (2012). Comparative Report ofHealth Literacy in Eight EU Member States, TheEuropean Health Literacy Survey HLS-EU  http://ec.europa.eu/chafea/documents/news/  Comparative_report_on_health_literacy_in_eight_  EU_member_states.pdfʅ2017 ĵ 1 ž 16 Ŵàƹʆ
B{cDm\~L{R{[)Ā9Ų(ɪ:Ɛȱ(1995). B{cDm\~L{R{[)Ā9Ų(ɪ:Ɛȱćòż http://www.umin.ac.jp/inf-consent.htm
ʅ2017 ĵ 1 ž 16 ŴàƹʆǢĪɴ~ɣñĶĒ(ǘ) (2013). ; 8)×ǓLlr^KNt{.î# ǸßÂƺǧ
ǢĪɴ~ưǽ (2013). ×ǓLlr^KNt{(:¼íŏŉƥėÁȐ ; 8)×ǓLlr^K
Nt{.î#, 126-139
ǢĪɴ (2015). ey%#)ĘÏ%ǟş>ş #)«ɹ>Ł: DRUG MAGAZINE, 59(1), 25-28
ǢĪɴ(ȇȞ) (2017). ɿʁȑɄ)Llr^KNt{ǣǮ l_x|@żŘīǱǞ (1999). Ǐǐƒɖ)ɌŦ%ŐƋŊʈŷȢ~ÔƻđŐƋǑ)Ôî 8ʈ þɲÚÏȿɵ, 7(2), 131-152
King, J. S. & Moulton, B. (2006). Rethinking Informed   Consent: The Case for Shared Medical Decision Making, American, Journal of Law & Medicine, 32,429-501
ǌƌɛɳ (2002). ×Ǔū%êƪÅŰ Å¥TBmPǧ
Makoul, G. and Clayman, M.L. (2006). An integrative  model of shared decision making in medical
 encounters, Patient Education and Counseling, 60:  301-312
Nakayama, K., Osaka, W., Togari, T., Ishikawa, H., Yonekura, Y., Sekido, A., and Matsumoto, M. (2015).
 Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment
 of health literacy, BMC Public Health, 15: 505ɣñĶĒ~ǢĪɴ~ĢƉ (2015). ÖĕǓƪ( :ŋȑ)¼íŏŉƥė(!#)ȹɂ 7,ƵɊĺ%)ɪ¨ ƇĎĕĎĕɯōćĕǂōćĕǣǮȽƍǣǮȇ,31, 89-113
President’s Commission (1982). Making health care decisions: A report on the ethical and legal implications
 of informed consent in the patient-practitioner  relationship https:// bioethicsarchive.georgetown.edu/ pcbe/reports/past_commissions/ making_health_care_ decisions.pdfʅ2017 ĵ 1 ž 16 ŴàƹʆɡǇǻĒ (2008). fxPwYvNǣǮ%ýżɽōćĕ Ãɣ)ɪ ʊțİơî°Ļ×ĕōćMaP)ĆǙ
 %# Library and Information Science, 59, 117-146.
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J.M., Slonska, Z., and Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models, BMC Public Health, 12: 80
Sørensen K., Van den Broucke S., Pelikan J.M., Fullam J., Doyle G., Slonska Z., Kondilis, B., Stoffels, V., Osborne, R.H., and Brand, H. (2013). Measuring
 health literacy in populations: illuminating the design
 and development process of the European Health Literacy Survey Questionnaire(HLS-EU-Q), BMC
 Public Health, 13: 948
Stivers, T. (2005). Parent Resistance to Physicians’  Treatment Recommendations: One Resource for Initiating a Negotiation of the Treatment Decision, Health Communication, 18(1): 41-47
Whitney, S. N., McGuire, A. L., and McCullough, L. B.  (2004). A Typology of Shared Decision Making, Informed Consent, and Simple Consent, Annals of Internal Medicine, 140(1), 54-59