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A Systematic Review of Shared Decision-Making in Cleft Care
Alicia Reil1, Reann Post1, Paul Hong2
1Faculty of Medicine, Dalhousie University, Halifax, Canada.
Summary
Shared decision-making (SDM) is valued by parents and patients in cleft lip and/or palate (CL/P) care. Further research is needed to integrate SDM effectively into routine CL/P treatment protocols.
Area of Science:
- Healthcare delivery
- Pediatric care
- Patient engagement
Background:
- Shared decision-making (SDM) is a collaborative approach involving healthcare providers, patients, and families.
- Cleft lip and/or palate (CL/P) care requires multidisciplinary input and patient/family involvement.
- Understanding patient and parent perspectives on SDM in CL/P care is crucial for optimizing treatment.
Purpose of the Study:
- To explore the utilization and perception of shared decision-making (SDM) in pediatric cleft lip and/or palate (CL/P) care.
- To identify key themes and factors influencing SDM within the CL/P patient population.
- To assess the value placed on SDM by parents and patients in CL/P treatment.
Main Methods:
- A systematic literature search was conducted across PubMed, CINHAL, Embase, and Dentistry & Oral Sciences Database.
- Studies focusing on SDM in pediatric CL/P care (patients <19 years) were included, with no date, language, or design restrictions (excluding case studies/systematic reviews).
- Qualitative data analysis identified recurring themes related to decision-making processes.
Main Results:
- Thirteen studies were included in the review.
- Parents reported high perceived involvement in SDM.
- Pediatric patients also reported high perceived involvement, with desire for SDM increasing with age.
- Key themes identified included understanding of cleft care, factors influencing autonomy, psychosocial aspects, and moral responsibility.
Conclusions:
- Shared decision-making (SDM) is highly valued by both parents and patients in the context of cleft lip and/or palate (CL/P) care.
- Further research is necessary to effectively integrate SDM into standard CL/P care protocols.
- Future studies should address the gap between perceived and actual SDM involvement and identify barriers/enablers for implementation.
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