电子评估工具能否改善共同决策过程?系统性综述。

Nyantara Wickramasekera, Sarah K Taylor, Elizabeth Lumley, Thomas Gray, Emma Wilson, Stephen Radley
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摘要

背景:患者参与决策在提高医疗质量方面发挥着重要作用。尽管如此,共同决策并未得到常规实施。然而,医护人员在就诊前使用电子评估工具来了解患者的病史、症状、意见和价值观,以促进共同决策:评估电子评估工具在改善共同决策过程中的有效性:方法:按照 PRISMA 指南进行系统性回顾。在 MEDLINE、EMBASE 和 PsycINFO 上检索已发表的文献,以确定潜在的相关研究。提取数据并进行叙述性分析:本综述共收录了 17 篇文章,代表了 4004 名参与者。主要研究结果表明,与对照组相比,干预组在患者与医护人员的沟通以及医护人员对患者病情的管理方面有明显改善。与此相反,相对较少的研究对患者-医护人员满意度和时间效率进行了评估,这些结果的影响尚无定论:本综述发现,由于使用了电子问卷,沟通和医护人员对患者病情的管理得到了改善。这一点令人鼓舞,因为共同决策过程依赖于医护人员与患者之间的高质量沟通:我们发现,这种干预措施对慢性病患者尤为重要,因为他们需要与医疗服务提供者建立长期关系,并同意符合其价值观的治疗方案。我们需要使用经过验证的工具进行更严格的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Can electronic assessment tools improve the process of shared decision-making? A systematic review.

Background: Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients' history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making.

Objective: To assess the effectiveness of electronic assessment tools to improve the shared decision-making process.

Method: A systematic review was conducted following PRISMA guidelines. Published literature was searched on MEDLINE, EMBASE and PsycINFO to identify potentially relevant studies. Data were extracted and analysed narratively.

Results: Seventeen articles, representing 4004 participants, were included in this review. The main findings were significant improvement in patient-provider communication and provider management of patient condition in the intervention group compared to the control group. In contrast, patient-provider satisfaction and time efficiency were assessed by relatively few included studies, and the effects of these outcomes were inconclusive.

Conclusion: This review found that communication and healthcare professional's management of a patient's condition improves because of the use of electronic questionnaires. This is encouraging because the process of shared decision-making is reliant on high-quality communication between healthcare professionals and patients.

Implications: We found that this intervention is especially important for people with chronic diseases, as they need to establish a long-term relationship with their healthcare provider and agree to a treatment plan that aligns with their values. More rigorous research with validated instruments is required.

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