治療やスクリーニングの決定に成人を巻き込むための患者による決定支援
Dawn Stacey1,2, France Légaré3, Krystina B Lewis1
1School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
JAMA
|August 16, 2017
まとめ
患者による意思決定補助器具 (PtDAs) は,患者の意思決定の質を向上させ,より情報と関与を感じるようにすることで,患者の健康選択の仕方を改善します. 患者や医療システムに悪影響を及ぼしません
科学分野:
- 意思決定科学
- 医療サービス研究
- 患者中心のケア
背景:
- 患者中心のケアには 効果的な共同意思決定が不可欠です
- 患者による意思決定支援 (PtDA) は,情報に基づいた選択を支援するために設計されたツールです.
- PtDAの総合的な影響に関する証拠は,まだ進化しています.
研究 の 目的:
- PtDAと意思決定の質の関連性を評価する.
- 意思決定プロセスに対する PtDA の影響を評価する.
- PtDA が患者や医療システムに 影響するかどうかを判断する.
主な方法:
- ランダム化制御試験の体系的レビューとメタ解析
- PtDAを使用した介入と通常の治療または非PtDA対照の比較
- 意思決定の質,プロセス対策,健康/システムの成果を含む成果の評価
主要な成果:
- PtDAは決定の質の向上と関連しており,決定が証拠と患者価値と一致することを保証しました.
- PtDAを使用している患者は,より情報があり,より明確な価値観を持ち,意思決定により積極的に参加していると報告しています.
- PtDAの使用により,患者または健康システムのアウトカムが悪化した証拠はありません.
結論:
- 患者による意思決定は 患者による選択の質と 意思決定の質を高めます
- PtDAは,患者やシステムの成果を損なうことなく,情報に基づいた,価値に基づいた意思決定をサポートします.
- PtDAは,医療における共同意思決定の改善のための効果的なツールです.
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