Obeidat Rana F, Homish Gregory G, Lally Robin M
Faculty of Nursing, Zarqa University in Jordan.
Oncol Nurs Forum. 2013 Sep;40(5):454-63. doi: 10.1188/13.ONF.454-463.
PURPOSE/OBJECTIVES: To examine the extent to which shared decision making is a concept addressed within the published, empirical oncology decision-making research originating from non-Western countries from January 2000 to January 2012 and provide an overview of the outcomes of this research.
MEDLINE®, CINAHL®, Google Scholar, PsycINFO, Web of Science, and PubMed were searched for oncology decision-making literature published in English from January 2000 to January 2012.
Charles's three-stage conceptual framework of shared decision making was used as an organizational framework for the 26 articles meeting the initial criteria and reporting on at least one decision-making stage.
Although most patients wanted to be informed of their diagnosis, patient preferences for information and participation in decision making differed from that of physicians and varied among and within cultures. Few studies in this review addressed all three stages of shared decision making. Physician and patient attitudes, preferences, and facilitators and barriers to potential successful adoption of shared decision making in non-Western cultures require additional study.
Nurses should assess patients from non-Western countries regarding their knowledge of and desire to participate in shared decision making and provide decision support as needed.
Shared decision making may be new to patients from non-Western cultures, necessitating assessment, education, and support. Non-Western patients may value having family and friends accompany them when a cancer diagnosis is given, but assumptions based on culture alone should not be made. Nurses should determine patient preferences for diagnosis disclosure, information, and participation in decision making.
目的/目标:探讨在2000年1月至2012年1月期间发表的、来自非西方国家的实证肿瘤学决策研究中,共同决策这一概念的涉及程度,并概述该研究的结果。
检索MEDLINE®、CINAHL®、谷歌学术、PsycINFO、科学网和PubMed,以获取2000年1月至2012年1月期间以英文发表的肿瘤学决策文献。
查尔斯的共同决策三阶段概念框架被用作26篇符合初始标准并报告至少一个决策阶段的文章的组织框架。
尽管大多数患者希望了解自己的诊断情况,但患者对信息的偏好以及参与决策的情况与医生不同,且在不同文化之间和文化内部存在差异。本综述中很少有研究涉及共同决策的所有三个阶段。医生和患者的态度、偏好以及非西方文化中潜在成功采用共同决策的促进因素和障碍需要进一步研究。
护士应评估来自非西方国家患者对共同决策的了解程度和参与意愿,并根据需要提供决策支持。
共同决策对于来自非西方文化的患者可能是新事物,因此需要进行评估、教育和支持。非西方患者在得知癌症诊断时可能重视家人和朋友的陪伴,但不应仅基于文化做出假设。护士应确定患者对诊断披露、信息以及参与决策的偏好。