Determinants of shared decision-making between people with dementia and informal caregivers: A systematic review

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-05-01 DOI:10.1016/j.pec.2025.108815

Huanran Liu , Vivian W.Q. Lou , Tianhong Mo

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引用次数: 0

Abstract

Objectives

Shared decision-making (SDM) between people with dementia and their caregivers is essential for home care arrangements. However, systematic understanding of influencing factors remains limited. This study aimed to identify modifiable determinants of shared decision-making and explore underlying theoretical mechanisms.

Methods

A comprehensive search across seven databases yielded fourteen studies, extracted using Covidence, including study design, decision topics, determinants, primary outcome, and theoretical frameworks. Quality assessment was based on the Critical Appraisal Skills Programme Qualitative Checklists and Cohort Study Checklists.

Results

Results showed that twelve studies used qualitative or mixed methods, with determinants primarily focusing on individual factors (e.g., PwD symptoms, caregiver burden), while interpersonal, community, and societal levels were overlooked. Care arrangement decisions were underexplored, and research lacked robust theoretical foundations.

Conclusions

Current research focuses predominantly on individual-level factors while paying less attention to modifiable determinants from broader levels. The insufficient attention to care arrangement decisions and theoretical frameworks calls for a more comprehensive approach.

Practice implications

Using Social Ecological Model, SDM interventions should simultaneously address individual needs, prioritize modifiable interpersonal factors, and incorporate broader environmental determinants to create comprehensive support systems on dementia caregiving.

查看原文本刊更多论文

痴呆患者和非正式照护者之间共同决策的决定因素：一项系统综述

目的痴呆患者与其照护者之间的共同决策（SDM）对家庭照护安排至关重要。然而，对影响因素的系统认识仍然有限。本研究旨在确定共同决策的可变决定因素，并探讨其潜在的理论机制。方法在7个数据库中进行综合检索，获得14项研究，使用covid提取，包括研究设计、决策主题、决定因素、主要结局和理论框架。质量评估基于关键评估技能项目质量检查表和队列研究检查表。结果12项研究采用定性或混合方法，决定因素主要集中在个体因素（如PwD症状、照顾者负担），而忽略了人际、社区和社会层面。护理安排决策未得到充分探讨，研究缺乏坚实的理论基础。结论目前的研究主要集中在个人层面的因素，而对更广泛层面的可改变决定因素的关注较少。对护理安排决策和理论框架的关注不足，需要更全面的方法。使用社会生态模型，SDM干预措施应同时满足个人需求，优先考虑可改变的人际因素，并纳入更广泛的环境决定因素，以创建痴呆症护理的综合支持系统。

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

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.