A Joanna Briggs Institute Framework Approach to Shared Decision Making in End-of-Life

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2024-10-07 DOI:10.1111/hex.70041

Marta Gil Glaría, María Martín Fernández, Carla Salgado, María José Hernández-Leal

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引用次数: 0

Abstract

Aim

To implement shared decision-making (SDM) through a patient decision aid (PtDA) for the initiation of palliative care (PC) in end-of-life (EOL) cancer patients.

Methodology

A comprehensive Scoping Review was conducted on SDM in PubMed, CINAHL and PsycInfo. An evidence-based implementation of PtDAs was created using the Joanna Briggs Institute framework, which followed rigorous pillars: (1) context, (2) facilitation and (3) evaluation.

Results

Fifteen studies were identified and categorised into (1) Implementation characteristics and (2) Strategies for implementing SDM in terminally ill cancer patients. SDM should consider the decision-making location, optimal timing, participants and decision type. Strategies include professional training, PtDAs and implementation programmes. A PtDA implementation protocol in video format for deciding to initiate PC is proposed, following International Patient Decision Aid Standards (IPDAS) and Clinical Practice Guidelines (CPG).

Conclusions

SDM implementation should be guided by evidence-based methodological models justifying and structuring its execution, especially in complex and interdisciplinary contexts. National or international frameworks facilitate the adoption of health innovations, such as PtDAs, benefiting patients and improving their usage.

Practice Implications

SDM is not just a concept but an important approach to the Care of cancer patients at EOL, enhancing patient satisfaction and improving care quality. The success and sustainability of SDM hinge on the fundamental aspects of staff training, interdisciplinary collaboration and ongoing evaluation. The lack of specific aid in Spanish underscores the immediate need for local development. Further research is needed in this area, as most reviewed studies did not measure SDM effectiveness in diverse hospital settings.

Patient or Public Contribution

This proposal was developed based on the experience and input of the nursing staff from the healthcare service where it is intended to be implemented.

Abstract Image

查看原文本刊更多论文

乔安娜-布里格斯研究所（Joanna Briggs Institute）生命末期共同决策框架方法。

目的：通过患者决策辅助工具（PtDA）实施共同决策（SDM），为生命末期（EOL）癌症患者启动姑息治疗（PC）：方法：在PubMed、CINAHL和PsycInfo上对SDM进行了全面的范围审查。采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的框架创建了基于证据的 PtDAs 实施方法，该方法遵循严格的支柱：（1）背景、（2）促进和（3）评估：结果：确定了 15 项研究，并将其分为（1）实施特点和（2）在癌症晚期患者中实施 SDM 的策略。SDM 应考虑决策地点、最佳时机、参与者和决策类型。策略包括专业培训、PtDA 和实施计划。根据《国际患者决策辅助标准》（IPDAS）和《临床实践指南》（CPG），以视频形式提出了决定启动 PC 的 PtDA 实施方案：结论：SDM 的实施应遵循循证方法模型，证明其合理性并构建其执行结构，尤其是在复杂和跨学科的情况下。国家或国际框架有助于卫生创新（如铂类衍生物）的采用，使患者受益并提高其使用率：SDM 不仅仅是一个概念，还是护理临终癌症患者、提高患者满意度和改善护理质量的重要方法。SDM 的成功和可持续性取决于人员培训、跨学科合作和持续评估等基本方面。缺乏西班牙文的具体援助强调了当地发展的迫切需要。这一领域还需要进一步研究，因为大多数综述研究并未衡量 SDM 在不同医院环境中的有效性：患者或公众的贡献：本建议是根据医疗服务机构护理人员的经验和意见制定的。

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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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.