Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument
Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument
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DOI：
10.1111/hex.12054
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发表时间：
2015-08-01
影响因子：
3.2
通讯作者：
Legare, France
中科院分区：
文献类型：
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作者：
Couet, Nicolas;Desroches, Sophie;Legare, France
背景我们不清楚卫生保健提供者在多大程度上让患者参与会诊期间的决策过程。研究策略我们在多个数据库中进行了在线文献检索(2001-12)，并通过网络收集进一步的数据。纳入标准(I)OPTION评分作为报告结果，(Ii)卫生保健提供者和患者作为研究参与者。数据提取提取的数据包括：(I)研究和参与者的特征和(Ii)选项结果(分数、统计关联和报告的心理测量结果)。我们还评估了选项结果报告的质量。主要结果我们发现了33项符合条件的研究，其中29项使用了修订后的量表。总体而言，我们发现患者参与行为的水平较低：在没有使用干预措施来实施共享决策(SDM)的情况下，平均选项得分为23+/-14(0-100分)。在评估时，与较高选项得分最一致的变量是实施SDM的干预措施(n=8/9)和会诊时间(n=8/15)。结论无论临床情况如何，很少有卫生保健提供者始终如一地试图促进患者参与，更少的卫生保健提供者根据患者的喜好调整护理。然而，SDM干预和更长时间的磋商都可以改善这一点。
Background We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this.Objective To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation.Search strategy We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.Inclusion criteria (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale.Data extraction Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting.Main results We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 +/- 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15).Conclusions Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this.