Evaluation of Shared Decision-Making Interventions in Pediatric Acute Care: A Systematic Review.

Q1 Nursing
Gemma Postill, Francine Buchanan, Sanjay Mahant, Ahastan Surees, Leo Hersi, Jessie Cunningham, Cornelia M Borkhoff, Nassr Nama, Peter J Gill
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引用次数: 0

Abstract

Context: There is limited consensus on the effectiveness of shared decision-making (SDM) interventions in pediatric acute care, where implementing SDM is particularly challenging.

Objective: To conduct a systematic review on the effectiveness of SDM interventions in pediatric acute care settings (PROSPERO: CRD42023394760).

Data sources: MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science, Scopus, and PsycInfo databases from inception to November 12, 2024.

Study selection: Studies that evaluated SDM intervention effectiveness for managing acute medical problems-those requiring an urgent or time-sensitive decision at the current clinical visit-in children and youth (aged <19 years).

Data extraction: Data were extracted on study participants, study design, clinical decision assessed, and patient-centered and clinical outcomes evaluated.

Results: Of 10 278 articles identified, 27 studies were included. These studies focused on acute respiratory infection (n = 5), intensive care unit decision (n = 5), head injury (n = 4), appendicitis (n = 4), febrile infant (n = 3), and other care decisions (n = 6). A breadth of outcome measures and measurement tools were used. In general, SDM interventions had positive impacts on patient-centered and clinical outcomes and were not accompanied by increased resource use, repeat health care utilization, or complications.

Limitations: Heterogeneity in SDM interventions and outcome measures limited the ability to conduct meta-analyses on intervention effectiveness.

Conclusions: SDM interventions have been evaluated in several pediatric acute care settings. Across a range of studies, SDM interventions were observed to improve patient-centered outcomes without increasing complications. Additional research using standardized outcome measurements is needed.

儿科急症护理中共同决策干预的评价:一项系统综述。
背景:关于共同决策(SDM)干预在儿科急症护理中的有效性的共识有限,其中实施SDM尤其具有挑战性。目的:对SDM干预在儿科急症护理中的有效性进行系统评价(PROSPERO: CRD42023394760)。数据来源:MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science, Scopus和PsycInfo数据库,时间从开始到2024年11月12日。研究选择:评估SDM干预对管理急性医疗问题的有效性的研究-那些需要在当前临床就诊时做出紧急或时间敏感决定的研究-在儿童和青少年(老年)中。数据提取:提取研究参与者、研究设计、临床决策评估以及以患者为中心和临床结果评估的数据。结果:在10278篇文献中,纳入了27篇研究。这些研究集中于急性呼吸道感染(n = 5)、重症监护病房决定(n = 5)、头部损伤(n = 4)、阑尾炎(n = 4)、发热婴儿(n = 3)和其他护理决定(n = 6)。使用了广泛的结果测量和测量工具。总体而言,SDM干预措施对以患者为中心的结果和临床结果有积极影响,并且不伴有资源使用增加、重复医疗保健使用或并发症。局限性:SDM干预措施和结果测量的异质性限制了对干预有效性进行荟萃分析的能力。结论:SDM干预措施已经在几个儿科急症护理环境中进行了评估。在一系列研究中,观察到SDM干预可以改善以患者为中心的结果,而不会增加并发症。需要使用标准化结果测量的进一步研究。
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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来源期刊
Hospital pediatrics
Hospital pediatrics Nursing-Pediatrics
CiteScore
3.70
自引率
0.00%
发文量
204
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