共享决策和预先护理规划:一个系统的文献审查和新的决策模型
Ana Rosca1, Isabelle Karzig-Roduner2, Jürgen Kasper3
1Clinical ethics, Stadtspital Zürich, Birmensdorferstrasse 497, Zürich, 8063, Switzerland. ana.rosca@stadtspital.ch.
BMC medical ethics
|August 14, 2023
概括
将共享决策 (SDM) 和预先护理计划 (ACP) 整合到一个单一的过程中,可以增强针对复杂疾病的以患者为中心的护理. 该模型通过将患者和临床医生的专业知识结合起来,确保了明智的选择,以便更好地做出治疗决策.
科学领域:
- 医学沟通 医学沟通
- 以患者为中心的护理
- 医疗保健道德 医疗保健道德
背景情况:
- 共享决策 (SDM) 和预先护理计划 (ACP) 对于患者的治疗选择至关重要,特别是对于那些有高并发症风险的人来说.
- 目前,SDM和ACP是推的,但尚未作为临床实践中的统一流程整合.
研究的目的:
- 评估SDM和ACP在患者护理中的当前应用,以大动脉狭窄患者为模型.
- 为改善患者决策提出一个结合SDM和ACP的综合模型.
主要方法:
- 在多个数据库 (Medline,Cinahl,Embase,Scopus,Web of Science,Psychinfo,Cochrane) 中进行了系统的文献审查.
- 专题分析和抽象推理被用来分析包括的15项关于SDM和ACP应用的研究.
主要成果:
- 十一项研究详细介绍了各种SDM步骤,四项研究重点是记录护理目标.
- 基于审查结果和现有证据,开发了一种集成SDM和ACP的新型模型.
结论:
- 让患者参与SDM和ACP都能促进立即和未来护理的明智决策.
- 综合方法促进了代过程,优先考虑信息并建立患者和医疗保健提供者之间的信任.
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