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Quality Management in Health Care 2020This review used the recent COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) rating system, which gives the reader the ability to...
BACKGROUND AND OBJECTIVES
This review used the recent COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) rating system, which gives the reader the ability to find appropriate instruments in a simple way. Shared decision-making (SDM) is part of health professionals', nurses', and patients' interaction about fundamental and special nursing care issues. The objective of this study was to critically appraise instruments that measure SDM in health care-related decisions according to the COSMIN criteria.
METHODS
This review was reported in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline. A thorough search identified SMD measures via PubMed, Cochrane Library, MEDLINE, EBSCO Host, Ovid journals, SAGE journals, and Google Scholar search engine through November 2018 and updated on March 24, 2019. A rating system with "very good," "adequate," "doubtful," or "inadequate" for COSMIN was used.
RESULTS
The 17 instruments reported in this review are varied in the measured perspectives; observer-based viewpoint, patient questionnaires, provider questionnaires, and physician questionnaires, or even mixed perspectives. Only one instrument (OPTION 12 Scale) received an excellent rating across all 5 COSMIN validity rating sections in content, structural, and criterion validity.
CONCLUSION
Most of the instruments scored poorly on the COSMIN checklist. Despite the vast number of instruments measuring SDM, researchers must undertake critical appraisal before selecting an acceptable instrument that meets the specific research goal, as well as the quality requirements.
Topics: Decision Making; Health Personnel; Humans; Patients; Professional-Patient Relations
PubMed: 32224789
DOI: 10.1097/QMH.0000000000000250 -
World Journal of Surgery Jun 2017Regret is a powerful motivating factor in medical decision making among patients and surgeons. Regret can be particularly important for surgical decisions, which often... (Review)
Review
OBJECTIVE
Regret is a powerful motivating factor in medical decision making among patients and surgeons. Regret can be particularly important for surgical decisions, which often carry significant risk and may have uncertain outcomes. We performed a systematic review of the literature focused on patient and physician regret in the surgical setting.
METHODS
A search of the English literature between 1986 and 2016 that examined patient and physician self-reported decisional regret was carried out using the MEDLINE/PubMed and Web of Science databases. Clinical studies performed in patients and physicians participating in elective surgical treatment were included.
RESULTS
Of 889 studies identified, 73 patient studies and 6 physician studies met inclusion criteria. Among the 73 patient studies, 57.5% examined patients with a cancer diagnosis, with breast (26.0%) and prostate (28.8%) cancers being most common. Interestingly, self-reported patient regret was relatively uncommon with an average prevalence across studies of 14.4%. Factors most often associated with regret included type of surgery, disease-specific quality of life, and shared decision making. Only 6 studies were identified that focused on physician regret; 2 pertained to surgical decision making. These studies primarily measured regret of omission and commission using hypothetical case scenarios and used the results to develop decision curve analysis tools.
CONCLUSION
Self-reported decisional regret was present in about 1 in 7 surgical patients. Factors associated with regret were both patient- and procedure related. While most studies focused on patient regret, little data exist on how physician regret affects shared decision making.
Topics: Adult; Aged; Attitude of Health Personnel; Attitude to Health; Decision Making; Elective Surgical Procedures; Emotions; Female; Humans; Logistic Models; Male; Middle Aged; Quality of Life; Surgeons; Surgical Procedures, Operative
PubMed: 28243695
DOI: 10.1007/s00268-017-3895-9 -
European Child & Adolescent Psychiatry Dec 2021Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors... (Review)
Review
Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.
Topics: Adolescent; Adult; Cognition; Decision Making; Gambling; Humans; Suicidal Ideation; Suicide, Attempted
PubMed: 32388626
DOI: 10.1007/s00787-020-01550-3 -
Frontiers in Public Health 2023Shared decision-making (SDM) facilitates the participation of healthcare professionals and patients in treatment decisions. We conducted a scoping review to assess SDM's...
BACKGROUND
Shared decision-making (SDM) facilitates the participation of healthcare professionals and patients in treatment decisions. We conducted a scoping review to assess SDM's current status in mainland China, referencing the Ottawa Decision Support Framework (ODSF).
METHODS
Our review encompassed extensive searches across six English and four Chinese databases, and various gray literature until April 30, 2021. Results were synthesized using thematic analysis.
RESULTS
Out of the 60 included studies, we identified three key themes based on the ODSF framework: decisional needs, decision support, and decisional outcomes. However, there appears to be a lack of comprehensive understanding of concepts related to decisional needs in China. Only a few studies have delved into feasibility, preference, choice, and outcome factors in the SDM process. Another challenge emerges from an absence of uniform standards for developing patient decision aids (PDAs). Furthermore, regarding health outcome indicators, their predominant focus remains on physiological needs.
CONCLUSION
SDM is in its infancy in mainland China. It is important to explore the concept and expression of decisional needs in the context of Chinese culture. Subsequent studies should focus on constructing a scientifically rigorous and systematic approach for the development of PDAs, and considering the adaptation of SDM steps to the clinical context in China during SDM implementation. Concurrently, The focus on health outcomes in Chinese SDM studies, driven by the unique healthcare resource landscape, underscores the necessity of prioritizing basic needs within limited resources.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/?s=202130021.
Topics: Humans; Asian People; China; Databases, Factual; Health Personnel; Decision Making, Shared; Delivery of Health Care; Decision Support Systems, Clinical
PubMed: 37744479
DOI: 10.3389/fpubh.2023.1162993 -
Resuscitation Nov 2019During resuscitation decisions are made frequently and based on limited information in a stressful environment.
BACKGROUND
During resuscitation decisions are made frequently and based on limited information in a stressful environment.
AIM
This systematic review aimed to identify human factors affecting decision-making in challenging or stressful situations in resuscitation. The secondary aim was to identify methods of improving decision-making performance under stress.
METHODS
The databases PubMed, EMBASE and The Cochrane Library were searched from their commencement to the 13th of April 2019. MeSH terms and key words were combined (Stress* OR "human factor") AND Decision. Articles were included if they involved decision makers in medicine where decisions were made under challenging circumstances, with a comparator group and an outcome measure relating to change in decision-making performance.
RESULTS
22,368 records in total were initially identified, from which 82 full text studies were reviewed and 16 finally included. The included studies ranged from 1995 to 2018 and included a total of 570 participants. The studies were conducted in several different countries and settings, with participants of varying experience and backgrounds. Of the 16 studies, 5 were randomised controlled trials, 3 of which were deemed to have a high risk of bias. The stressors identified were (i) illness severity (ii) socio-evaluative, (iii) noise, (iv) fatigue. The mitigators identified were (i) cognitive aids including checklists, (ii) stress management training and (iii) meditation.
CONCLUSIONS
Human factors contributing to decision-making during resuscitation are identified and can be mitigated by tailored stress training and cognitive aids. Understanding these factors may have implications for clinician education and the development of decision-support tools.
Topics: Cardiopulmonary Resuscitation; Decision Making; Decision Support Techniques; Humans; Injury Severity Score; Severity of Illness Index; Stress, Psychological
PubMed: 31562904
DOI: 10.1016/j.resuscitation.2019.09.023 -
Health Expectations : An International... Dec 2015Assessment of users' information and decision-making needs is one key step in the development of decision-support interventions. (Review)
Review
BACKGROUND
Assessment of users' information and decision-making needs is one key step in the development of decision-support interventions.
OBJECTIVE
To identify patients' information and decision-making needs as a pre-requisite for the development of high-quality web-based patient decision aids (PtDAs) for common mental disorders.
SEARCH STRATEGY
A systematic MEDLINE search for papers published until December 2012 was conducted, and reference lists of included articles and relevant reviews were searched.
INCLUSION CRITERIA
Original studies containing data on information or decision-making needs of adults with depression, anxiety disorders, somatoform disorders, alcohol-related disorders and schizophrenia were included.
DATA EXTRACTION AND SYNTHESIS
Data extraction was performed using a standardized form, and data synthesis was conducted using a theory-based deductive approach by two independent reviewers. Studies were quality assessed using the Mixed Methods Appraisal Tool.
MAIN RESULTS
Twelve studies were included focusing on information needs or the identification of decisions patients with depression and schizophrenia were facing. No studies were found for the other mental disorders. Overall, seven information needs categories were identified with the topics 'basic facts', 'treatment' and 'coping' being of major relevance. Six decision categories were identified of which decisions on 'medication' and 'treatment setting' were most often classified.
CONCLUSIONS
This review reveals that patients with schizophrenia and depression show extensive information and decision-making needs. The identified needs can initially inform the design of PtDAs for schizophrenia and depression. However, there is an urgent need to investigate information and decision-making needs among patients with other mental disorders.
Topics: Decision Making; Decision Support Techniques; Humans; Information Seeking Behavior; Mental Disorders
PubMed: 25145796
DOI: 10.1111/hex.12251 -
BMC Medical Ethics Aug 2023Shared decision making (SDM) and advance care planning (ACP) are important evidence and ethics based concepts that can be translated in communication tools to aid the...
BACKGROUND AND AIMS
Shared decision making (SDM) and advance care planning (ACP) are important evidence and ethics based concepts that can be translated in communication tools to aid the treatment decision-making process. Although both have been recommended in the care of patients with risks of complications, they have not yet been described as two components of one single process. In this paper we aim to (1) assess how SDM and ACP is being applied, choosing patients with aortic stenosis with high and moderate treatment complication risks such as bleeding or stroke as an example, and (2) propose a model to best combine the two concepts and integrate them in the care process.
METHODS
In order to assess how SDM and ACP is applied in usual care, we have performed a systematic literature review. The included studies have been analysed by means of thematic analysis as well as abductive reasoning to determine which SDM and ACP steps are applied as well as to propose a model of combining the two concepts into one process.
RESULTS
The search in Medline, Cinahl, Embase, Scopus, Web of science, Psychinfo and Cochrane revealed 15 studies. Eleven describe various steps of SDM while four studies discuss the documentation of goals of care. Based on the review results and existing evidence we propose a model that combines SDM and ACP in one process for a complete patient informed choice.
CONCLUSION
To be able to make informed choices about immediate and future care, patients should be engaged in both SDM and ACP decision-making processes. This allows for an iterative process in which each important decision-maker can share their expertise and concerns regarding the care planning and advance care planning. This would help to better structure and prioritize information while creating a trustful and respectful relationship between the participants. PROSPERO 2019. CRD42019124575.
Topics: Humans; Decision Making; Decision Making, Shared; Advance Care Planning; Records; Documentation; Patient Participation
PubMed: 37580704
DOI: 10.1186/s12910-023-00944-7 -
European Journal of Cancer Care Nov 2022We aimed to systematically evaluate quality of shared decision-making (SDM) in colorectal cancer (CRC) screening clinical practice guidelines (CPGs) and consensus... (Review)
Review
INTRODUCTION
We aimed to systematically evaluate quality of shared decision-making (SDM) in colorectal cancer (CRC) screening clinical practice guidelines (CPGs) and consensus statements (CSs).
METHODS
Search for CRC screening guidances was from 2010 to November 2021 in EMBASE, Web of Science, MEDLINE, Scopus and CDSR, and the World Wide Web. Three independent reviewers and an arbitrator rated the quality of each guidance using a SDM quality assessment tool (maximum score: 31). Reviewer agreement was 0.88.
RESULTS
SDM appeared in 41/83 (49.4%) CPGs and 9/19 (47.4%) CSs. None met all the quality criteria, and 51.0% (52/102) failed to meet any quality items. Overall compliance was low (mean 1.63, IQR 0-2). Quality was better in guidances published after 2015 (mean 1, IQR 0-3 vs. mean 0.5, IQR 0-1.5; p = 0.048) and when the term SDM was specifically reported (mean 4.5, IQR 2.5-4.5 vs. mean 0.5, IQR 0-1.5; p < 0.001). CPGs underpinned by systematic reviews showed better SDM quality than consensus (mean 1, IQR 0-3 vs. mean 0, IQR 0-2, p = 0.040).
CONCLUSION
SDM quality was suboptimal and mentioned in less than half of the guidances, and recommendations were scarce. Guideline developers should incorporate evidence-based SDM recommendations in guidances to underpin the translation of evidence into practice.
Topics: Humans; Colorectal Neoplasms; Decision Making; Decision Making, Shared; Early Detection of Cancer; Patient Participation
PubMed: 36254840
DOI: 10.1111/ecc.13738 -
Journal of the Academy of... 2022Decision-making capacity can be affected by psychiatric illness. Women who have psychiatric illness who make decisions about their reproductive health may require... (Review)
Review
BACKGROUND
Decision-making capacity can be affected by psychiatric illness. Women who have psychiatric illness who make decisions about their reproductive health may require evaluation of their decision-making capacity.
OBJECTIVE
This article aims to characterize existing literature about capacity evaluations in women with psychiatric illness making reproductive decisions.
METHODS
We conducted a systematic review searching PubMed, EMBASE, Ovid PsycINFO, and ClinicalTrials.gov databases through July 2020. Articles were evaluated for relevance to inclusion criteria, first by title and abstract screening then by reading the full text of articles. Our inclusion criteria were case reports and studies that involved women of childbearing age with psychiatric illness making obstetrical decisions for whom decision-making capacity was evaluated. We qualitatively analyzed our data by examining themes within the studies, such as the circumstances of the referral and characteristics of reproductive decision-making. We also collected information about the clinical circumstances, such as the clinical setting (e.g., inpatient or outpatient, in primarily psychiatric or obstetric care) and who made the determination of capacity.
RESULTS
We identified 18 articles, which included 22 distinct patient cases and 27 distinct obstetrical decisions. Decisions about termination of pregnancy were most common, which were 10 of 27 decisions. Decisions about timing and mode of delivery accounted for 7 and 5 decisions, respectively. The most common psychiatric diagnosis reported was schizophrenia, which was present in 8 patients. Major depression and bipolar disorder were also frequently reported, present in 3 and 5 patients, respectively.
CONCLUSION
Patients who make health care decisions must have decision-making capacity. A patient with psychiatric illness does not inherently lack capacity, and in fact, most patients with psychiatric illness have decision-making capacity. Psychiatric illness, however, can add complexity to obstetrical medical decision-making. Reasons for this complexity include the involvement of many stakeholders, the often time-sensitive nature of these decisions, and the potentially unpredictable course of psychiatric illness. Successful management of these cases involves multidisciplinary collaboration, the use of preventative ethics through advanced care planning, and identification of a guardian or surrogate decision-maker when a patient is determined to lack decision-making capacity or for a patient who has capacity through advanced care planning.
PROSPERO REGISTRATION NUMBER
CRD42020143434.
Topics: Bipolar Disorder; Decision Making; Female; Humans; Mental Disorders; Pregnancy; Schizophrenia
PubMed: 34461294
DOI: 10.1016/j.jaclp.2021.08.007 -
The Journal of Pediatrics Dec 2022To synthesize and describe important elements of decision-making during antenatal consultation for threatened preterm delivery at the margin of gestational viability.
OBJECTIVE
To synthesize and describe important elements of decision-making during antenatal consultation for threatened preterm delivery at the margin of gestational viability.
STUDY DESIGN
Data sources including PubMed, EMBASE, Web of Science, and CINAHL Plus were searched. We included all qualitative literature published on decision-making from 1990 to July 2021. Two authors independently screened and evaluated each study using the Critical Appraisal Skills Programme checklist; studies reaching moderate and high quality were included. We developed an extraction tool to collect and categorize data from each qualitative article, then used thematic analysis to analyze and describe the findings.
RESULTS
Twenty-five articles incorporating the views of 504 providers and 352 parents were included for final review. Thematic analysis revealed 4 main themes describing the experience of health care providers and parents participating in decision-making: factors that influence decision-making, information sharing, building a partnership, and making the decision. Parents and providers were not always in agreement upon which elements were most essential to the process of decision-making. Articles published in languages other than English were excluded.
CONCLUSIONS
Qualitative literature highlighting key factors which are important during antenatal counseling can inform and guide providers through the process of shared decision-making. Communicating clear, honest, and balanced information; avoiding artificially dichotomized options; and focusing on partnership building with families will help providers use the antenatal consultation to reach personalized decisions for each infant.
Topics: Infant, Newborn; Infant; Female; Humans; Pregnancy; Infant, Extremely Premature; Decision Making; Parents; Health Personnel; Information Dissemination; Qualitative Research
PubMed: 35940293
DOI: 10.1016/j.jpeds.2022.07.017