Analysis of Influencing Factors and Strategies of Implementing Shared Decision-Making Among Patients with Gastrointestinal Cancer: A Systematic Review and Meta-analysis of Qualitative Studies.

Abstract

Background: Over the past 50 years, doctor-patient interactions have moved from paternalistic to patient-centered, emphasizing shared decision-making (SDM). SDM, which involves healthcare professionals and patients making clinical decisions together, is crucial for patient autonomy and is promoted worldwide, yet remains challenging to implement effectively. Our systematic review analyses the influencing factors of implementing shared decision-making in patients with colorectal cancer and summarizes coping strategies.

Materials and methods: A systematic search of the PubMed, Embase, Cochrane Library, Web of Science (Core library), Ovid, and EBSCO databases was performed from database inception to 1 September 2024 using a combination of subject words and free words. Qualitative studies on the factors affecting SDM for patients with gastrointestinal cancer were identified, the literature quality was evaluated using the Australian JBI Evidence-based Health Care Center quality evaluation standards for qualitative research, and the results were integrated by a pooled integration method.

Results: A total of 37 results were extracted through meta-analysis, summarized into 9 themes, and summarized into 2 subthemes. The results were classified for nonmutually exclusive cases.

Conclusions: Medical staff should fully understand patients' needs and preferences for disease and treatment information, strengthen their communication skills regarding SDM, and actively provide effective treatment and care information for patients and their families to promote the implementation of SDM for patients with gastrointestinal tumors.