Fisher Alana, Manicavasagar Vijaya, Kiln Felicity, Juraskova Ilona
School of Psychology, University of Sydney, NSW 2006, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, NSW 2006, Australia.
School of Psychiatry, University of New South Wales, NSW 2031, Australia; Black Dog Institute, University of New South Wales, NSW, 2031, Australia.
Patient Educ Couns. 2016 Jul;99(7):1106-1120. doi: 10.1016/j.pec.2016.02.011. Epub 2016 Feb 23.
To systematically review studies of communication and decision-making in mental health-based samples including BP patients.
Qualitative systematic review of studies using PsychINFO, MEDLINE, SCOPUS, CINAHL, and EMBASE (January 2000-March 2015). One author assessed study eligibility, verified by two co-authors. Data were independently extracted by two authors, and cross-checked by another co-author. Two independent raters assessed eligible studies using a validated quality appraisal.
Of 519 articles retrieved, 13 studies were included (i.e., 10 quantitative/1 qualitative/1 mixed-methods). All were cross-sectional; twelve were rated good/strong quality (>70%). Four inter-related themes emerged: patient characteristics and patient preferences, quality of patient-clinician interactions, and influence of SDM/patient-centred approach on patient outcomes. Overall BP patients, like others, have unmet decision-making needs, and desire greater involvement. Clinician consultation behaviour influenced patient involvement; interpersonal aspects (e.g., empathy, listening well) fostered therapeutic relationships and positive patient outcomes, including: improved treatment adherence, patient satisfaction with care, and reduced suicidal ideation.
This review reveals a paucity of studies reporting bipolar-specific findings. To inform targeted BP interventions, greater elucidation of unmet decision-making needs is needed.
Eliciting patient preferences and developing a collaborative therapeutic alliance may be particularly important in BP, promoting improved patient outcomes.
系统回顾以心理健康为基础的样本（包括双相情感障碍患者）中沟通与决策的研究。
对2000年1月至2015年3月期间使用PsychINFO、MEDLINE、SCOPUS、CINAHL和EMBASE数据库检索到的研究进行定性系统回顾。由一位作者评估研究的纳入资格，并由两位共同作者进行核实。数据由两位作者独立提取，并由另一位共同作者进行交叉核对。两位独立的评估者使用经过验证的质量评估方法对符合条件的研究进行评估。
在检索到的519篇文章中，纳入了13项研究（即10项定量研究/1项定性研究/1项混合方法研究）。所有研究均为横断面研究；12项研究被评为质量良好/较高（>70%）。出现了四个相互关联的主题：患者特征和患者偏好、患者与临床医生互动的质量，以及共享决策/以患者为中心的方法对患者结局的影响。总体而言，双相情感障碍患者与其他患者一样，存在未得到满足的决策需求，并且希望更多地参与决策。临床医生的咨询行为影响患者参与度；人际关系方面（如同理心、良好倾听）促进了治疗关系和积极的患者结局，包括：提高治疗依从性、患者对护理的满意度以及减少自杀意念。
本综述显示，报告双相情感障碍特异性研究结果的研究较少。为了为有针对性的双相情感障碍干预措施提供信息，需要更深入地阐明未得到满足的决策需求。
在双相情感障碍中，了解患者偏好并建立协作性治疗联盟可能尤为重要，有助于改善患者结局。
