围绕在紧急医疗中共享决策的上下文敏感实施的文献中的挑战:一个范围审查
Felix Wehking1, Friedemann Geiger2, Fueloep Scheibler2
1Department of Emergency Medicine, University Hospital Jena, Jena, Germany.
Open access emergency medicine : OAEM
|September 19, 2025
概括
在紧急医疗领域的共同决策表明,在不损害患者安全的情况下,有望节省资源. 然而,研究使用了多种不同的术语,并排除了高风险患者,这需要进一步调查.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 共享决策 (SDM) 是一种协作式的医疗保健方法.
- 它在紧急医疗中的应用面临着独特的挑战,但有越来越多的证据基础.
- 这次审查批判性地评估了文献,并确定了研究缺口.
研究的目的:
- 批判性地评估当前关于紧急医疗共享决策的文献.
- 确定挑战,并为该领域的未来研究工作提供信息.
- 综合关于SDM对患者结果和资源利用的影响的研究结果.
主要方法:
- 根据PRISMA和PECOS的方法进行范围审查.
- 包含有关紧急环境中的协作护理的定性和定量研究.
- 数据来源包括主要的数据库;数据合成由研究人员进行.
主要成果:
- 综合了34项随机试验和观察性研究.
- 研究主要来自美国,专注于决策辅助工具.
- 随机试验显示了异质的结果,其中一些表明咨询时间增加了2分钟,但对患者安全没有妥协.
结论:
- 在紧急医疗中对SDM的研究使用了各种术语,并且经常排除高风险患者.
- 现有证据表明,在不损害患者安全的情况下,有潜在的节约资源效应.
- 据报道,讨论时间的增加被认为是有争议的,需要进一步研究.
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