Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.
Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.
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DOI：
10.1186/1472-6947-14-25
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发表时间：
2014-04-03
影响因子：
3.5
通讯作者：
Onwuteaka-Philipsen BD
中科院分区：
文献类型：
--
作者：
Brom L;Hopmans W;Pasman HR;Timmermans DR;Widdershoven GA;Onwuteaka-Philipsen BD
越来越多的人期望并要求患者参与医疗保健决策。在这个决策过程中，参与的偏好是很重要的。在这个系统的回顾，我们的目的是提供一个概述的文献相关的一致性之间的患者的偏好和他们的感知参与医疗决策。我们还探讨了与一致性相关的不匹配和轮廓因素的方向。对患者参与医疗决策进行系统回顾。检索了截至2012年9月的Medline、PsycINFO、CINAHL、EMBASE和Cochrane图书馆数据库，并对所有研究进行了严格的批判性评估。共纳入44篇论文，他们的样本包含52个不同的患者样本。决策偏好和感知参与之间的平均一致性为60%（49和70分别代表第25和75百分位数）。如果没有发现一致性，36例患者样本中大多数患者倾向于更多的介入，9例患者样本中大多数患者倾向于较少的介入。被调查最多的与偏好相关的因素是年龄和教育水平。年轻的患者和受过高等教育的患者一样，更喜欢积极或共同的角色。这篇综述表明，对所有患者采用类似的方法不太可能满足患者的愿望，因为患者对参与的偏好各不相同。卫生保健专业人员应该对患者的个人偏好敏感，并在他们的疾病轨迹中定期沟通患者的参与意愿。
Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients’ preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. This review suggests that a similar approach to all patients is not likely to meet patients’ wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients’ participation wishes on a regular basis during their illness trajectory.
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影响因子：
45.3
作者：
Butow, P;Devine, R;Tattersall, MHN
通讯作者：
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影响因子：
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作者：
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通讯作者：
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