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共同决策是否能为患有疼痛性肌肉骨骼疾病的个体带来更好的健康相关结果?一项系统综述。

Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review.

作者信息

Tousignant-Laflamme Yannick, Christopher Shefali, Clewley Derek, Ledbetter Leila, Cook Christian Jaeger, Cook Chad E

机构信息

School of Rehabilitation, Physiotherapy Program, Université de Sherbrooke, Sherbrooke, Canada.

School of Health Sciences, The University of Newcastle, Callaghan, Australia.

出版信息

J Man Manip Ther. 2017 Jul;25(3):144-150. doi: 10.1080/10669817.2017.1323607. Epub 2017 May 9.

Abstract

: Shared Decision-Making (SDM) is a dynamic process by which the health care professional and the patient influence each other in making health-related choices or decisions. SDM is strongly embedded in today's health care approaches, and is advocated as an ideal model since it renders individuals more control towards the health care they choose to receive, and has been shown to improve patient outcomes. : The goal of this systematic review was to investigate the added-value of SDM on clinical health-related outcomes in patients with a variety of musculoskeletal conditions. : PubMed and CINAHL. : PRISMA guidelines were followed for this review. To be considered for review, the study had to meet all the following criteria: (1) prospective studies that involved treatment decision-making; (2) randomized controlled trial design; (3) involving patients faced with having to make a treatment decision; (4) comparing SDM with a control intervention and (5) including one or more of the following outcome measures: well-being, costs, health-related pain or disability measures, or quality of life. : A priori, we determined to perform methodological quality assessment using the Cochrane Risk of Bias tool for randomized controlled trials. : We did not find a single study that looked at the true effect of SDM on patient reported outcomes in a population with musculoskeletal pain. : For the management of painful musculoskeletal conditions, in the light of the current evidence (none), we estimate that it would be wise to explore the effectiveness of SDM before forcing its large-scale implementation in rehabilitation.

摘要

共享决策(SDM)是一个动态过程,在此过程中医疗保健专业人员和患者在做出与健康相关的选择或决策时相互影响。SDM深深植根于当今的医疗保健方法中,并被倡导为一种理想模式,因为它使个人对其所选择接受的医疗保健有更多控制权,并且已被证明能改善患者的治疗效果。:本系统评价的目的是调查SDM对各种肌肉骨骼疾病患者临床健康相关结局的附加价值。:PubMed和CINAHL。:本评价遵循PRISMA指南。要被纳入评价,研究必须满足以下所有标准:(1)涉及治疗决策的前瞻性研究;(2)随机对照试验设计;(3)涉及面临治疗决策的患者;(4)将SDM与对照干预进行比较;(5)包括以下一项或多项结局指标:幸福感、成本、与健康相关的疼痛或残疾指标或生活质量。:预先,我们决定使用Cochrane偏倚风险工具对随机对照试验进行方法学质量评估。:我们没有找到一项研究来观察SDM对肌肉骨骼疼痛人群中患者报告结局的真实影响。:对于疼痛性肌肉骨骼疾病的管理,鉴于目前的证据(无),我们估计在强制其在康复中大规模实施之前,探索SDM的有效性是明智的。

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