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Published on: February 16, 2011
Shared decision-making in palliative care: a systematic mixed studies review using narrative synthesis
Emmanuelle Bélanger1, Charo Rodríguez, Danielle Groleau
1Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada. emmanuelle.belanger@mail.mcgill.ca
Palliative Medicine
|January 29, 2011
Summary
Patients in palliative care often desire more involvement in treatment decisions but face barriers like delayed discussions and limited options. More research is needed on shared decision-making (SDM) processes in this setting.
Area of Science:
- Palliative Care
- Health Sciences
- Medical Ethics
Background:
- Shared decision-making (SDM) is crucial in palliative care to align treatment with patient values.
- Existing literature on the SDM process in palliative care is limited.
- Understanding patient preferences for involvement is key.
Purpose of the Study:
- To synthesize current knowledge on the process of shared decision-making (SDM) in palliative care.
- To identify gaps in the literature regarding SDM in this context.
Main Methods:
- Systematic literature search across multiple databases (Medline, EMBASE, CINAHL, PsychInfo, Web of Science).
- Inclusion criteria focused on original research with adult patients in Western contexts.
- Narrative synthesis using thematic analysis, conceptual mapping, and critical reflection.
Main Results:
- Most patients desire some level of participation in treatment decisions.
- Patients frequently do not achieve their preferred involvement due to delayed decisions and undiscussed options.
- The literature specifically detailing the SDM process in palliative care is scarce.
Conclusions:
- Further research is essential to elucidate the complex, longitudinal, interactive, and interdisciplinary nature of decision-making in palliative care.
- Interventions to improve SDM processes are needed to better meet patient preferences.
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